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Document Request Form

for libraries and information agencies worldwide



Sections marked with a red dot must be completed

Requestor Requires

mandatory Service level Core Rush Express
mandatoryPlease supply my document by fax by mail electronically
Please provide Photocopy Quote for Total Cost
Date not wanted after

Requesting Library

NUC Symbol (Australia only)
Name of Library (If applicable)
mandatoryName of Institution / Government Dept. / Organisation

Delivery Address

PO Box/Number/Street/etc.
Suburb
State
Country
Post Code

Contact Details

mandatoryPhone
Fax
mandatoryEmail

Please fill in either
Section A if you are requesting a photocopy of a journal article
OR
Section B if you are requesting a photocopy from a book, conference paper or report

Do not fill in both sections - use a new form

SECTION A Photocopy of Journal Article

Call number (if known)
Journal name
Volume details Volume Issue
Date Pages
ISSN (if known)
Author of article
Title of article

SECTION B Photocopy from Book / Conference / Report

Call number (if known)
Title of book etc.
Author or Editor in format Surname, Firstname.
Publisher
Place of Publication
Publication Date
Edition or No
ISBN
(if known)
Section to be Copied  
Author of Section
Title of Section
Page Numbers

Further information

Requestor Comments
mandatoryDeclaration (select box) This request complies with section 50 of the Australian Copyright Act


For more information contact Interlibrary Loans and Document Delivery