Image Reuse Request Form

Reuse of an image previously obtained from the Gallery may be permitted when the Applicant can provide verification of the Gallery as the image source.

The information requested below will assist us in determining the feasibility of your order. Submission of the request does not guarantee the Gallery's fulfillment of the order nor does it obligate the Applicant to the Gallery's related terms and conditions. You will receive a contractual agreement by post or fax summarizing the details and total cost of the order. Please follow the instructions contained therein to finalize the order. You will be notified in the event that the order cannot be fulfilled.

Thank you for your interest in the National Gallery of Art collections.

Mailing Name/Address

Name

Organization

Mailing Address (no P.O. Box, please)

Telephone

E-mail

Billing Name/Address

If you would like your order billed to a different party, please complete the following.

Name

Organization

Billing Address (no P.O. Box, please)

Telephone

E-mail

Project Information: Reuse

Please provide specific information for your proposed reuse of the image: for example, book title, author, publisher, cover or interior usage, nonprofit or commercial status of applicant/publisher, and print run.

Source of Image and Project Information: First Use

Please describe the project for which you previously requested the image.

If you would like the agreement sent by fax, please provide your number.

Fax Number

Image List

For each work of art, please include artist's name, title of work, accession number, and whether the image will appear in color or black and white.