RESEARCH REQUEST FORM

Please print out the form.  It may be mailed or faxed to the library. Signature and prepayment required.

NAME__________________________________________________PHONE___________________________

COMPANY_______________________________________________________________________________

ADDRESS________________________________________________________________________________

CITY, STATE, ZIP____________________________________________________________________________

Discover/MC/ VISA/ AE #_______________________________________EXP DATE____________________

MAXIMUM AMOUNT TO BE SPENT for additional photocopies at 25 cents per page _____________________

RESEARCH REQUEST

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

Note: Your signature on this document affirms that you will use any/all photocopies from the Colorado Historical Society for research purposes only: not to be transcribed or reproduced without written permission from the owner of the rights to the materials.

      Signature ___________________________________  Date _______________________

RETURN TO:    

Stephen H. Hart Library
Colorado Historical Society
1300 Broadway
Denver, CO  80203  
Phone 303 866 2305    
FAX  303 866 4204