| Phillips House |
|
The Film Collection: Research Request Form Back to The Film Collection |
| Requestor: Name
(please print): _____________________________________________________________ Title: ___________________________________________________ Organization/Institution: ____________________________________ Address: _______________________________________________________________________ Phone
number: ____________________________Fax number: ___________________________ Purpose
of research (check all that apply): Brief description of above project or research: ___________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Describe
the films you wish to view (please use AF numbers from on-line finding aid): ________________________________________________________________________________ ________________________________________________________________________________ Date
and time you wish to visit (please note that the film collection is open
to researchers by appointment only during business hours, Monday-Friday, 10-4
p.m.):
Mail or fax or this form to:
Phillips House 34 Chestnut Street, Salem, MA 01970 Fax (978) 740-1086 | Phone (978) 744-0440
FOR
STAFF USE ONLY Date received: _______________ Received by: ____________________ Date approved: ______________ Approved by: ____________________ Approval granted to view
the following films: _________________________________________________________________________________ _________________________________________________________________________________ Notes: ___________________________________________________________________________ _________________________________________________________________________________ Date access completed: ____________________ Completed by: ___________________________ Staff time required: ________________________ |