I understand and agree to the conditions and restrictions as stated.
I submit that the analysis of the samples is intended for academic research only, and is not for commercial purposes.
| _____________________________________________________________________________
[Institution and address, requesting permission.] | ||
| __________________________________ Researcher name/title (print) |
_____________________________ Signature of researcher |
________________ Date |
| __________________________________ Advisor or host name/title (print) | _____________________________ Signature of advisor or host [if student or visitor] | ________________ Date |
| For Smithsonian Institution use only | ||
| We have reviewed the request and [grant] [deny] permission for the sampling of herbarium specimens, with the restrictions stated above. | ||
| _________________________________ Representative of the Smithsonian Institution, U.S. National Herbarium |
__________________________ Signature |
_________________ Date |