Anna Leonowens Archives & Collections Research Access Form

Individual requests for physical access will be considered case by case, upon review of completed Research Access Form. Specific holdings or use copies are generally available for review or retrieval, by appointment, 2 weeks after a request is submitted.

Access to the Gallery Archives may occur through supervised interaction with records, images, fine art objects, physical and digital documents. Proposed projects related to personal and academic research, publication (including web sites, electronic media and promotional materials), media events, films, and advertising may be permitted.

Name Name * First Last
Email *
Institution affiliation *
Nature and Purpose of Research:
Please describe or list the kind of information that you are seeking, and the purpose(s) for which it is being collected. *
Privacy Act:
In obtaining access to personal information under the provisions of paragraph 8(2)(J) of the Privacy Act, I hereby agree that; *

Privacy Act:
In obtaining access to personal information under the provisions of paragraph 8(2)(J) of the Privacy Act, I hereby agree that; No disclosure of information obtained from records of The Gallery will be made in a form that could reasonably expect to identify an individual to whom it relates without express written authority of The Gallery. The Gallery may seek written permission of a third party. Any personal information obtained will be used only for the purpose(s) described in Part II of this form and no subsequent use will be made without the express authority of The Gallery. All personal information obtained from records of The Gallery will be destroyed, rendered anonymous, or returned to the Gallery as agreed by The Gallery and the researcher prior to the release of information. I will at all times protect the information and preserve the physical integrity and confidentiality of the records to which I have access.
Copyright Act: *

Copyright Act: I understand that the material being provided by The Gallery may be subject to the Copyright Act R.S. C-42. I understand that the material may be used solely according to the fair dealing provisions in the Copyright Act for the purposes of the private study or research. I agree that it is my sole responsibility to ensure that the rights of the author provided by the Copyright Act are upheld and agree to indemnify The Gallery for any loss or damage that results or arises out of my use of these materials. I understand that failure to comply with these undertakings could result in the loss of research privileges at The Anna Leonowens Gallery, NSCAD University.
Researcher's signature:
Draw your signature into the box below. *

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.