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Application for research at Newtown Library

Name:
Tel No:
Email:
Address:
Research required	Please supply clear and concise details, and where possible records to be searched. (Please note: The form will reset to the 'blank' format after your research request has been sent)
Please indicate here of the amount of research time you require. Please do not send any money at this stage, the amount payable will be sent with the report. All research other than quick “look ups” will require a minimum of one hours research.
Copyright declaration in the event of photocopied published or unpublished material being supplied. I declare that: I have not previously been supplied with a copy of the same material by you or any other librarian; I will not use the copy except for research for a non-commercial purpose or private study and will not supply a copy of it to any other person; 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. Agree
(Office use only) Date received
(Office use only) Receipt No.
(Office use only) Ref. no.

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