Copyright request to QSA
TRIM Ref: 10/
Attention:
QSA Publishing Unit
Date:
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Details of material to be reproduced
Type of source material:
Title of publication:
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Source material is presented:
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Percentage of QSA material used, compared to the work as a whole:
Publication and distribution
The publication in which we wish to use copyright material:
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Quantity produced: (if conference or workshop, no. of attendees)
Distribution:
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(public)
Other: (please specifiy)
Sale price / Attendance fee:
Additional information:
Please send a draft copy of the work, demonstrating how QSA material is being used and acknowledged.
Email: [email protected]
Post: Manager, Publishing Unit, QSA, PO Box 307, Spring Hill QLD 4004
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QSA OFFICE USE ONLY
Permission is:
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Amount due:
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to use copyright material described above.
that I have authority to grant copyright permission for this work.
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Copyright request to QSA | Page 2 of 2