Special Collections and Archives, Queen’s University of Belfast Application to consult the Queen’s University of Belfast Archive Use of the Queen’s University of Belfast Archive is subject to the physical condition of the archives and copyright restrictions. Signing this form indicates your awareness of these restrictions. Name: Home address and email address (where applicable): Address and Telephone number while in Belfast: Occupation or name of Institution to which attached: Nature of the material to be consulted/Name of record series: Purpose of consultation (thesis, publication, family history): Signature: Date: All requests for copies from the Queen’s University of Belfast Archive must be made to the University Archivist. If the University Archivist allows copies to be made from the University Archive these copies are to be used for personal research purposes only. Permission to publish from the University Archive must be obtained from the Director of Information Services, Queen’s University of Belfast. In cases where Queen’s University does not hold the copyright to material held in the University Archive it is the responsibility of the Researcher to obtain permission from the copyright holder.