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 *

Please indicate whether you plan to upload and donate digital material now, or if you wish to pre-register to donate material at the Reunion on April 29. *

Online material donation

Pre-registration for donating materials on April 29

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.

File Upload

Multiple files may be uploaded at once using this tool.

Please upload any digitized photos or documents that you wish to donate to the archives here. Maximum individual file size is 10 MB, and maximum total upload size is 20 MB.

If your total file size exceeds 20 MB, please contact the Local History/Special Collections Branch at lhsc@alexlibraryva.org for additional instructions.

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.