of Art and History
1000 - Bruxelles
Tel: +32 (0)2 741.72.02
Fax: +32 (0)2 733.77.35
|Name of institution||
|Name of the contact person||
|Information on the object|
ex. Title, kind of object (image, furniture, tapestry…) etc.:
Quality of the digital image
|Yes, I am a student|
Students after presentation of their student card receive a discount of 50%
In case of re issue the reproduction right has to be paid again |
| Book / Article|
|Date of publication||
| Multimedia (cd-rom, website,...)|
1-The applicant agrees to send to the royal Museum of Art and History a complementary copy of the publication no later than one month after the publication.
2- The publication of any object belonging to the collections of the RMAH has to be labelled : © Royal Museums of Art and History, Brussels or © RMAH.
3- Under no circumstances can the photographic file be given by the applicant to a third party or be used for purposes other than those specified in this form.
4- The postal charges must be paid by the applicant.
5-Any photographic file ordered and received must be paid even when not used or published.
6- Upon receipt of the invoice, the amount is to be sent to the royal Museums of Art and History.
- for Belgium: postcheque, account number CCP. 679-1300105-14
- from abroad: Iban 'BE94 6791 3001 0514' and BIC 'PCHQBEBB'
|I accept the conditions mentioned above|