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INTER LIBRARY LOAN REQUEST FORM (PDF)

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					                                           DEPARTMENT OF PSYCHOLOGY
                            INTER-LIBRARY LOAN REQUEST FORM
THIS FORM IS TO BE USED BY PSYCHOLOGY STAFF AND POSTGRADUATE STUDENTS FOR REQUESTS FOR
                    ITEMS NOT HELD AT A UNIVERSITY OF MELBOURNE LIBRARY.

A HANDLING FEE IS CHARGED TO THE DEPARTMENT FOR EACH REQUEST. EACH REQUEST MUST BE
APPROVED BY YOUR SUPERVISOR AND A COPY SUBMITTED TOTHE DEPARTMENT OFFICE TO OBTAIN A $6
VOUCHER BEFORE IT IS SUBMITTED TO THE LIBRARY.



Name (in full)                                                                           ___ Date _________________________

Department:      Psychology          Student’s Course                                                    __     Year _____________
Email address or Contact Address ______________________________________________________________________
Postal Address _____________________________________________________________________________________
Phone (9-5): _________________________________________                            Last Date Required _______________________

Requestor's Borrowing Card Barcode No.         2 1290
                                                         -STUDENTS ONLY-


SUPERVISOR: _______________________________________________

SIGNATURE: ________________________________________________



JOURNAL ARTICLE: If you wish, attach a copy of the original reference and leave this section blank.

Journal title________________________________________________________________________________________
ISSN: _____________________Volume and issue ________________________year _______pages______________
Author(s) of article __________________________________________________________________________________
Title of article ______________________________________________________________________________________
_________________________________________________________________________________________________

BOOK/THESIS OR CONFERENCE PAPER                                                                    * Sign Copyright Declaration below


Author/s or Editors __________________________________________________________________________________

Title of Book/Thesis/Conference paper __________________________________________________________________

Place            ___            Publisher ____________                       _______ Year                        Edition ___________

If thesis, please note type eg PhD ______________________________________________________________________

Title of Chapter in Book/conf.paper ______________________________________________page no ________________

Author/s of chapter in book/conf paper                                                   ___________ISBN __________________


                                                                                                     * Sign Copyright Declaration below
LIBRARIES AVAILABLE AT: (Libraries and call numbers as displayed on NUCOS)



                                         ****** COPYRIGHT DECLARATION ******
NB: Where a requestor requires a copy to be supplied, the Copyright Declaration must be completed pursuant to S.49 (1) of the 1980
Copyright Amendment Act. I declare that I require the copy described on this form for the purpose of research or study and will not use it
for any other purpose and that I have not been supplied previously with a copy of the same article or work.

SIGNED                                                                     DATE OF DECLARATION
SECTION B (Overseas Request Only)
If the work you have requested is not available in Australia, please indicate below whether you wish the Library to obtain a
copy from overseas. Students must have this section of the form countersigned by their supervisor agreeing that
the Department will cover any additional ILL costs and/or the purchase of whole works on microform.



I REQUEST THAT THE WORK BE OBTAINED FROM OVERSEAS (Please tick)                                      YES             NO
SIGNED:                                                     _________________           DATE: ____________________________

BOOK REQUEST ONLY: Providing the work is out of copyright, would you prefer that a microform copy of the whole or
part of the work be obtained for purchase?

YES              NO                           PART (as indicated overleaf)                    PART (as indicated overleaf)


                  -PAYMENT FOR OVERSEAS LOANS: (IN ADDITION TO THE $6 HANDLING FEE) -


                                                                                              DEPARTMENT OFFICE STAMP
SUPERVISOR: _______________________________________________

SIGNATURE: ________________________________________________

Microform purchase approved (Please tick)                  YES            NO.


                                                      -LIBRARY USE ONLY-
Requested from                                                   Date                                   Date Received
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________



                         UNIVERSITY LIBRARY - INTER LIBRARY LOAN REQUEST AND DECLARATION
                                    UNDER S.49 OR S.50 OF THE COPYRIGHT ACT 1968

I, ___________________________________________being an authorised officer of the UNIVERSITY OF MELBOURNE, declare that:

1.      I have requested a copy of the work described overleaf, from the Library whose abbreviation appears overleaf.

2.      The purpose of the request is to:                                                                         (if applicable)


        a.       Include the copy in the collection of the University of Melbourne Library; or

        b.       Supply the copy to a person who has made a request to the University of Melbourne Library
                 for a copy under S.49 of the Copyright Amendment Act 1980

3.      A copy has previously been supplied to this Library by another for the purpose of inclusion in the collection, but has been
        lost/destroyed/damaged.

4.      The copy requested is the whole of a literary, dramatic or musical work (other than an article contained in a periodical
        publication) or of a part of such a work that contains more than a reasonable, portion of the work, and I further declare that after
        reasonable investigation, I am satisfied that a copy (not being a second-hand copy) of the work could not be obtained within a
        reasonable time at an ordinary commercial price.



Signed_________________________________________________________________ Date of Declaration ___________________

				
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Description: INTER-LIBRARY LOAN REQUEST FORM