Networking 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 four working weeks.
Send request to: Cambridge \| New York \| Melbourne

Name:
Address:


Town:
Post Code:
Country:
Email:
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Title of Cambridge book					Journal	Audio CD	CD- ROM

Title:

Year of publication:

Book

CD-ROM ISBN :

Journal volume and issue no:

Please confirm that you have purchased:

a copy of the book/CD-ROM	or are a subscriber to the journal

Networking Right Requested

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

Term for which right requested (give first and last date on which access to material is desired):

First date:

Last date:

Intranet site (give details of location(s) from which site may be accessed):

Approximate number of authorised users:

Security (give details of security in place, e.g. access by IP address only):

Usage (e.g. read–only; read and download for private research and study only):

Further details: