Academic Photocopying Request Form & Copyright Declaration Request Information Please supply me with a copy of *the article in the following periodical/the part of the following published work, the particulars of which are: Requested Item * required by me for the purposes of research or private study (one requested item per form). I declare that: (a) I have not previously been supplied with a copy of the same material by you or any other librarian; (b) I will not use the copy except for research for a noncommercial purpose or private study and will not supply a copy of it to any other person; (c) to the best of my knowledge no other person with whom I work or study has made or intends to make, at or about the same time as this request, a request for substantially the same material for substantially the same purpose. I understand that if the declaration is false in a material particular the copy supplied to me by you will be an infringing copy and that I shall be liable for infringement of copyright as if I had made the copy myself. Declaration acceptance * I agree to the declaration Your Details Full name * Address * Email address * Date * Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year20192020202120222023 VAT number (if applicable) Leave this field blank
