Name:

Email Address:

On behalf of (group/class):

Names of your exhibit team members and their UM department or affiliation:

Library or SSW staff member liaison (optional):

Requested Exhibit Dates:

Is this exhibit associated with a campus event or national observance? If yes, please provide name and dates of event and/or observance:

Exhibit Title:

Subject or Theme:

Exhibit Description:

Library Materials to Be Exhibited (List titles and call numbers of library materials to be included in exhibit):

.

The University Library (including the Social Work Library) cannot provide security or insurance for privately owned items. All exhibit items are displayed at the owner's risk.

I agree to these terms: Yes No

.

Check types of materials to be exhibited:

Library materials Objects Photocopies

Note: If items are being reproduced, has coypright permission been secured? Yes No

Physical Requirements

Please describe the physical requirements of this exhibit (see SWL Exhibit Policy for information on available space and resources):

Publicity and Events

Please describe publicity such as press releases, newspaper articles, websites planned for this exhibit:

To submit this form in paper copy, complete, print out and send to Jennifer Nason Davis, Social Work Library, B704 School of Social Work Building, University of Michigan, Ann Arbor, 48109-1106.