Exhibit Development Request

Contact Information

Requested By

Responsible Official (Borrower)

Contact Institution

Contact Address

Contact Phone

Phone

Contact Email

Requested Exhibit Name

Requested Installation Period

Note:Maximum of 6 months.

Please provide date range in the following format: "MM/DD/YYYY to MM/DD/YYYY"

Will host require help with installation?

Yes

Installation Space and Environmental Information

Installation Space Size

Please provide space size in the following format: __' x __'

Additional Information about space size

Describe security and environmental controls

Please be as specific as possible

How will access to the exhibit be managed?

Average temperature and relative humidity in installation space (if available)

Can the host institution insure the exhibit during the loan?

Yes

Please provide any additional information about installation space, environment, and security.

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