Individual Request to Copy an Unpublished Thesis for Research & Study

Please complete all sections of the form. A separate form is required for each thesis copy request.


To: Document Delivery, The University of Sydney Library


Please supply me with a copy of the following thesis:

Thesis Information

Author
Title
Degree
Date conferred

Your Information

Name
Address
Contact Number
Email Address

Copyright Declaration


If the material is an UNPUBLISHED THESIS or similar, then the material may be reproduced under Section 51(2) for the purpose of research and study only.

   SECTION 51(2) DECLARATION I declare that I require a copy of the above stated unpublished thesis or similar material for the purpose of research or study and will not use it for any other purpose. I have not previously been supplied with a copy of this thesis by an unauthorised officer of the library.


Signed ______________________________________________________


Date _________________
This information is required for copyright administration and ordering purposes and as such all fields are compulsory. Supplied information will be held secure and will not be disclosed for any other purpose than the above stated.



Method of Payment

Price:
  • Within Australia: AUD $165.00 (incl. GST)
  • Other countries: AUD $150.00
Please check one box
   Mastercard    Visa

Cardholder Name

Cardholder Number
Expiry date

   Cheque

   AUD$ Bank Draft/ Money Order

Payable to: The University of Sydney Library

   Invoice


Please check all sections are completed, print the form and:
Fax: +61  2   9351 4593 

or

Email: library.supply@sydney.edu.au

or

Mail:
Document Delivery (Theses)
Fisher Library, FO3
University of Sydney
NSW 2006
Australia