The Art Institute of Chicago
Image Licensing Form

Image Licensing Request Form

Fill out the form below and click the SUBMIT button.

Part 1: Contact Information

*Required Fields
*First Name:
*Last Name:
Company:
Department:
*Telephone:
Fax Number:
Alt. Telephone:
*E-mail Address:
Internet Address/
URL:
*Address 1:
Address 2:
*City:
State/Region:
Postal Code:
Country:
*User Type:


Part 2: Art Object Information and Reproduction Type
Reproduction Type:

Please provide the artists' name, title of work, date, medium, and accession number (when available) for all requested works.

Special Instructions.

Part 3: Project Information

Please provide the information applicable to your project. If needed, provide additional information in the comments field.

Usage Type:
Media/Format:
Publication/Project Title:
Author:
Publisher/Producer:
Publication/Release Date:
Geo. Distribution Area/
Territory:
Language(s):
Print Run/Circulation:
Project Internet Address/
URL:
Duration:
Image Size:
Retail/Unit Price:
Comments:

Please review your information. 
Requests submitted with insufficient information may
experience delays in processing.

 

 

     
 

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