Application for Use of the Marion E. Wade Center Reading Room

Research

Title

First Name *

Last Name *

Street Address *

Street Address, Line 2

City *

State/Province *

Zip/Postal Code *

Country (if non-US)

Phone Number

Email Address *

Purpose of Visit

Author(s) of Interest

Topic of Research *

Anticipated Dates at Wade

Professional Affiliations and Publication Information (if applicable)

Institution

Title or Position

Academic Level of Research

Highest Degree Completed

Director of Research

Other Publications

Expected Date of Publication

Proposed Title of Publication

Please note that we request a copy of your finished work to be sent to the Wade Center as part of the agreement for using our materials.

I request permission to use the Marion E. Wade Center for the project described above. I have read the regulations for the use of the Center, agree to abide by them and plan to deposit a copy of my finished work here.

*

I agree that typing my name below constitutes my digital signature.

Signature *

Date *

Please add me to the Wade Center email list for news and events

Type of Photo ID - Required Upon Arrival (for office use)