Interlibrary loan request form

Library Services

Please Note: If you are requesting a book you are required to complete fields 1, 2, 5, 6 and 8 ONLY. If you are requesting a photocopied article please complete all mandatory fields.

Resource 1

1) Author(s):*

2) Full title or source:*

3) Title of chapter/article:

4) Volume/issue no:

5) Publisher:

6) Date of publication:

7) Page number(s):

8) ISBN/ISSN:

Resource 2

1) Author(s):*

2) Full title or source:*

3) Title of chapter/article:

4) Volume/issue no:

5) Publisher:

6) Date of publication:

7) Page number(s):

8) ISBN/ISSN:

Resource 3

1) Author(s):*

2) Full title or source:*

3) Title of chapter/article:

4) Volume/issue no:

5) Publisher:

6) Date of publication:

7) Page number(s):

8) ISBN/ISSN:

Copyright declaration (applies to photocopy requests only)

Complete the declaration (choose one option only) type your name and date.

Please make and supply to me a copy of the above article(s). Copy is required for:

use with students or teacher professional development (e.g. classroom use or in-service for teachers).
the execution of duties as a State employee.
the purpose of personal research or study (e.g. tertiary studies).

I have not previously been supplied with a copy by an authorised officer of the library.

Name:*

Date:*

Please remember my contact details for future requests. (Do not check this box if using a public computer and you want to keep your contact details private.)

Privacy: Personal information provided by you will be used solely for the purpose of managing resources borrowed from the library and will not be disclosed to third parties without your consent. For further information, view our privacy statement.

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Interlibrary loan request form

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Resource 1

Resource 2

Resource 3

Copyright declaration (applies to photocopy requests only)

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Interlibrary loan request form

Delivery details for all items

Resource 1

Resource 2

Resource 3

Copyright declaration (applies to photocopy requests only)

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