Oglala Lakota College Archives

490 Piya Wiconi Road
Kyle, SD 57752

(605) 455-6063 Fax: 455-6070
archives@olc.edu

REQUEST FOR SERVICE

 

Name (please print) __________________________________________  Date of Request____________________

 

Daytime Phone _____________________Fax ________________  E-mail ________________________________ 

 

Mailing Address_______________________________________________________________________________

 

Type of Service(s) Requested:   ____ Photocopies   ____ Microform copies   ____ Research   ____ Photographic

                                                            ____ Scanned copies   ____ Video copies    ____ Audio copies

 

Source(s):  Collection / Title of Book_______________________________________________________________

 

Box #_____________  Folder # _____________ Call #___________ Roll #___________ Object #_____________

 

Request(s):  Description of item(s)_________________________________________________________________

 

_____________________________________________________________________________________________

 

Delivery:    ____ Pick-up      ____ Mail (hardcopy)     ____ Mail (disk)     ____ Fax     ____ E-mail

 

Date Documents Needed: ________________________ (Requests will be completed as staff time is available. Please allow 2 weeks for all services. No rush orders are available.)

 

Fees:                                      _____  Publication Fees                                     ________

(see Fee Schedule &            _____  Photocopies @ 15˘ each                      ________

Publication Fees)                 _____  Microforms @ $1.00 each                     ________

_____Groups to research @ $10.00 each        ________

_____  Hours to research @ $20.00 each        ________

_____  Pages fax delivery @ $2.00 each          ________

_____  Pages e-mail delivery @ $2.00 each     ________

_____  Images e-mail delivery @ $5.00 each   ________

_____  Images on disk @ $5.00 each               ________

_____  Disks @ $2.00 each                                ________

_____  Audiocassette or CD-R @ $5.00 ea.    ________

_____  Videocassette or DVD-R @ $8.00 ea   ________

_____   Postage fee @ $1.00 per order             ________

                                                TOTAL:                ________

 

Payment Method:    ____ Cash    ____ Credit Card    ____ Money Order    ____ Check - # ___________

 

Date Payment Rec’d _______________                        Date Documents Delivered _______________

 

The OLC Archives provides copies of requested materials with the explicit understanding that the materials are not to be used for any purpose other than private study, scholarship or research. If you use these materials for more than any other “fair use,” you may be liable for copyright infringement. The copyright law of the United States (Title 17, U.S. Code) governs the making of photocopies or other reproductions of copyrighted materials. The OLC Archives is not liable for any infringement of this law by its patrons.  The OLC Archives reserves the right to refuse service if copying may damage materials, or if the order is too large for staff to accommodate. Please see the Researcher Guidelines for further information.

 

I, the undersigned, agree to abide by U.S. copyright law and the researcher guidelines of the OLC Archives.

 

SIGNATURE ______________________________________________________________________