RESEARCH REQUEST FORM

Please print out the form.  It may be emailed or mailed. 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 _____________________
MAXIMUM AMOUNT TO BE SPENT for additional research time at $20.00 per 1/2 hour___________________

RESEARCH REQUEST

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Note: Your signature on this document affirms that you will use any/all photocopies from History Colorado 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:    

History Clorado
Colorado Historical Society
1560 Broadway, 4th floor
Denver, CO  80202
research@chs.state.co.us