Rochester Museum & Science Center
657 East Avenue
Rochester, NY 14607
Tel: 585-271-4320
Fax: 585-271-0492
http://www.rmsc.org/

Request for Access to Collections and Related Records

Name: 

Institutional affiliation: 
Work address: 
Work telephone: 
Work Fax: 

Home address: 
Home telephone: 

E-mail: 

Student? [y/n]: 

Project title: 

Brief description of purpose: 

Collections/records you wish to examine: 

Names of other individuals, other than RMSC staff, who will be involved in this work: 

Will it be necessary to work on any collections materials outside the RMSC? [y/n]: 

Does your project involve any destructive analysis? [y/n]: 

Does your project involve any photography? [y/n]: 

Does your project involve any use of RMSC records? [y/n]: 

Attachments:

Proposal [y/n]: 

List of objects with accession and/or catalogue numbers (if possible) [y/n]: 

Current resume of applicant(s) [y/n]: 

Letter of recommendation from project supervisor (students only) [y/n]: 

Names of references [y/n]: 

Completed Facility Report (if off-site research is necessary) [y/n]: 



Your signature below indicates your willingness and ability to comply with the following:

I will conduct my work at the RMSC between 9am  and 5pm, Monday through Friday.

I will observe access and security regulations relating to the use of RMSC collections and study rooms.

I will observe guidelines for handling collections, including possible restrictions regarding what collections may be handled.

I will observe restrictions of how and where photography may take place.






[signature of applicant]	[date]


Request for Access - rev. 2008-03-25