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Photocopy Request Form

Date:
Please complete this form as fully as possible. Our aim is to provide an initial reply to your request within no more than two working weeks.
Name:
Address:


Town:
Post Code:
Country:
Email:
Fax:
Telephone:

Title of Cambridge publication:

Author		Editor

Name:

Book ISBN:
or
Journal volume and issue no:

Permission Requested:

Material to be reproduced (give full details including author and article title where appropriate; page number(s) for extract / figure number(s) / etc.):

Number of copies:

Organisation undertaking photocopying if not requester:

Usage:

	For inclusion in a course pack by an educational institution distributed free of charge or

	at cost of photocopying only

	For internal distribution by a not-for-profit company (not for resale)

	For distribution by a commercial company internally or to clients (not for resale)

	For commercial distribution

Further details:

Send request to: Cambridge | New York | Melbourne