Library Services
Department of Education and Training
347 Old Cleveland Road, Coorparoo Q 4151
PO Box 1238, Coorparoo DC Q 4151
Telephone: +61 7 3421 6539
Facsimile: +61 7 3421 6503
Email: Inquiries.LIBRARY@deta.qld.gov.au
ABN: 76 337 613 647 Company Code: EDUC

Photocopy request form for curriculum articles

Complete the form below to submit your details online. To post or fax your details, download the request form (new window 97k ).

* Denotes mandatory fields

Requester details

Date of request:*

Indexing service:*Guidelines Newscan

Index issue:

Subject heading:

* I have completed a Requester Agreement form and confirm that this request constitutes a signed copy.

Name:


Surname*	Given names*	Title

School:*

Position:*

Email:*

PIN:*

Photocopy request

A copy is requested of the work described below:

Journal title:*

Article title:*

Author(s):

Vol:

No:

Date:*

Pages:*

Copyright declaration

Complete the declaration (choose one option only) and enter the student's details.

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

including the item in our Resource Centre collection
supplying it to one of our users.

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

Name of student:

Class:

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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Last updated: February 2009