Permission to publish - University of Glasgow

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Permission to publish
Please use this form to notify us of your intention to reproduce copies of documents, or extracts of
documents, which we hold.
Your details
Full name:
Address:
E-mail address:
Tel No.:
Publication, exhibition or broadcast details
Title:
Publisher/Broadcaster:
(include contact details)
Description of way to be used:
(eg academic text book, school
documentary, dates of
exhibition)
Number of times to be shown
(broadcasts):
Ref. Nos. and descriptions of
items you propose to use:
(continue on a separate sheet if
necessary)
Total number of items you
propose to use:
Probable date of publication:
DECLARATION
I have read, understood and accept the conditions governing the reproduction of copies of documents
and the GUAS leaflet on Copyright. I undertake that if permission to reproduce items is granted in
compliance with the request made above, I will ensure that any appropriate fee and a complimentary
copy are forwarded before publication.
Signed:
Date:
Please complete all sections and send to the address below
Note: Faxed and electronic copies are not acceptable. A separate application to obtain copies for research purposes must also be
completed where appropriate. Permission to reproduce an item does not obviate the need to obtain any necessary consent from the
copyright owner(s).
Archive Services, 13 Thurso Street,
University of Glasgow, Glasgow, G11 6PE
Tel: +44 (0) 141 330 5515 Fax: +44 (0) 141 330 2640
Email: [email protected]
URL: www.gla.ac.uk/archives
The University of Glasgow, charity number SC004401
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