ART01 - Photograph Application for Use PHOTOGRAPH APPLICATION FOR USE The Geraldton Regional Art Gallery (GRAG) has an extensive photographic record of artworks held in the City of Greater Geraldton Art Collection. The release of photographs in many instances will be dependent on the Copyright Owner's Condition of Use. If the intended purpose of the application does not meet these conditions, the images will not be released. Applicant Details Name*This field is required. * Required Field. Address*This field is required. * Required Field. Telephone Number*This field is required. * Required Field. Alternate Contact Number Email Address*This field is required. * Required Field.* Please enter a valid email address. Photograph Details Requested Items Intended use of image Select an Option Non-Commercial (eg. Research) Commercial (eg. Publications for sale or advertising) If selected "Non-Commercial Options," select from the below: Select an Option Photocopy (regular costs apply for printing) Digital Copy (no charge) If selected "Commercial Option," select from the below: Select an Option Photocopy (regular costs apply for printing) Digital Copy (Cost per image) Please refer to the City's website for the Schedule of Fees and Charges (Development and Community Services), these fees and charges all include GST and are updated annually on the 1 July. Conditions of Use Conditions of Use I understand that this application is for one (1) use only and that use of the artwork image must be acknowledged in the following way: [Copyright Owner as advised], courtesy of the Geraldton Regional Art Gallery. I have agreed to submit this application by electronic means. I can confirm that the information given in this application is true, complete and accurate. By checking this box and typing my name below, I am electronically signing my application*This field is required. YesNo * Required Field. Signature*This field is required. * Required Field. The City of Greater Geraldton collects the personal information you provide in relation to the Photograph Application for Use Form so we can deliver the service, process your request, and meet our legal obligations under the Local Government Act 1995 and any other related legislation. Your information may be shared with government agencies, contractors, or others where authorised by law or with your consent. Where required by law, your personal information will be made publicly available, e.g. public registers. The City manages personal information in accordance with relevant privacy legislation and takes reasonable steps to protect it from unauthorised access or disclosure. You may request access to, or correction of, your personal information by contacting the City at privacy@cgg.wa.gov.au. Type the code from the image: The code you entered is not valid. Get Audio CodeType the code from the image Was this page helpful? How can we improve this page? Email Address*This field is required. * Required Field.* Please enter a valid Email Address Type the code from the image: Do not fill this textbox.