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IL Department of Natural Resources 1. Permission to use an image is restricted to one time use only and may not be reproduced, copied, projected or used in any way without (a) express written permission from IDNR stating the rights granted and the terms thereof and (b) payment of said invoice. 2. Credit line to appear next to the image will read: Illinois Department of Natural Resources, photographer name (if available). 3. Mail completed form and check payable to:
Request for Reproduction Permission (Please Print) Name__________________________________ Title______________________________ Company or Agency________________________________________________ Address_______________________________________
City__________________ State___ Zip_________ Phone Number(daytime)______________ E-mail__________________________________________ Photograph appeared in:
OutdoorIllinois_________________________OutdoorIllinois calendar______________
Website image_______________________________Size print needed____________CD____ electronic___ email address_________________________________ Description of use: book____ magazine____ website_____ lecture presentation___ newspaper___poster___ brochure____ Name of publication, book, website address_____________________________ Applicant agrees to terms of this agreement.
For
Office Use only: # of images_________Total fees__________Date payment received______________
Date order received______________ Date ordered shipped________________
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