Scott County Public Library

APPLICATION TO EXHIBIT ART

I agree with the attached policy and understand the library does not insure exhibits.  I understand all reasonable precautions will be taken to protect my materials, but the library is not responsible for reimbursement or replacement of lost, stolen or damaged articles.

Signature______________________________________

Date:  ________________________________________

Please print

Name_________________________________________________________________________

Address_______________________________________________________________________

Phone_________________________________________________________________________

Date requested for exhibit

     Set up date:___________________________________

      Removal date:_________________________________

This application has been reviewed and approved by:

 Signature: ______________________________________

Date:   _________________________________________

Title:   _________________________________________