| |
| Journal 1 |
Title of journal
|
Year of publication
|
Author(s)
|
Volume/issue
|
Specify which
fig/table number/extract
|
Page
numbers
|
| Journal 2 |
Title of journal
|
Year of publication
|
Author(s)
|
Volume/issue
|
Specify which
fig/table number/extract
|
Page numbers
|
| Journal 3 |
Title of journal
|
Year of publication
|
Author(s)
|
Volume/issue
|
Specify which
fig/table number/extract
|
Page numbers
|
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| |
2. How will
the material be used?
(Please check as many as relevant)
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3. Where will the material be reproduced?
(Please complete as many of the
following as relevant)
|
Title of
book/journal/CD
|
Publication date
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URL
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Publisher
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Print
run/number of reproductions
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Individual
reprints -
please give details
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Please provide
any other information you feel is relevant:
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4. Your details
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Name*
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Address*
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Organisation*
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Email address*
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Phone number*
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Fax number
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Your reference
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