EmailMe Form - Black Family Reunion Digital Donation Form

Name *

First Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone *

### - ### - ####

Email *

Would you like to upload and donate digital materials online, or pre-register to donate materials in-person at the reunion on September 6, 2025? *

Online donation

In-person donation at reunion on 9/6/2025

Where to Upload Materials

After submitting this form, you will receive a confirmation email with a link to a submission portal where you can upload your digital donation. If you don’t receive an email or have any questions, please contact Local History / Special Collections staff at LHSC@alexlibraryva.org.

Once you submit this form, you will receive confirmation email with a form number in the subject line. Please have that form number available when you come to the Reunion so our staff can find your pre-registration form more quickly.

Upload Instructions

After submitting this form, you will receive a confirmation email with a link to a submission portal where you can upload your digital donation. If you don’t receive an email or have any questions, please contact Local History / Special Collections staff at LHSC@alexlibraryva.org.
Once you submit this form, you will receive confirmation email with a form number in the subject line. Please have that form number available when you come to the Reunion so our staff can find your pre-registration form more quickly.

Pre-Registration Instructions

If you are pre-registering and plan to donate materials at the Reunion, please complete the material description section below and provide a signature.

Once you submit this form, you will receive confirmation email with a form number in the subject line. Please have that form number available when you come to the Reunion so our staff can find your pre-registration form more quickly.

Brief descriptions of materials: *

BY SIGNING BELOW, I AGREE TO ALLOW THE ALEXANDRIA CITY LIBRARY TO BORROW AND DIGITIZE THE ITEM(S) DESCRIBED ABOVE FOR INCLUSION TO THE LIBRARY’S LOCAL HISTORY & SPECIAL COLLECTIONS.
I UNDERSTAND THAT THIS DIGITAL DONATION IS CONSIDERED A PERMANENT GIFT AND AGREE THAT DONATION IS GOVERNED BY THE LIBRARY’S GIFT POLICY AND THAT THE RETENTION, PRESERVATION AND DISPOSITION OF THE MATERIAL WILL BE MADE IN ACCORDANCE WITH LIBRARY POLICIES.
I ALSO AGREE THAT THIS MATERIAL WILL BE MADE AVAILABLE IN ACCORDANCE WITH THE LIBRARY’S ACCESS POLICIES, AND AS A RESULT OF THIS DIGITAL GIFT, RELEASE AND INDEMNIFY THE LIBRARY, ITS EMPLOYEES, AND BOARD MEMBERS, FROM ANY AND ALL CLAIMS ARISING OUT OF THE USE OF THESE MATERIALS, INCLUDING BUT NOT LIMITED TO ANY CLAIMS FOR DEFAMATION, COPYRIGHT VIOLATION, INVASION OF PRIVACY OR RIGHT OF PUBLICITY. *

Clear

Please provide your signature in the box above.