Department of Library Services

Dramatic, Artistic and Literary Rights Organisation (Pty./Ltd.) (DALRO)
PO Box 31627 Braamfontein 2107
E-mail: dalro@iafrica.com
URL: http://www.dalro.co.za
Tel.: +27 11 403 6635 Fax: +27 11 403 9094

Application for a transactional licence for reprographic reproduction from a BOOK
(For use by Educational Institutions not holding a Blanket DALRO Licence)

Details of Academic Staff Member Applying

Copies to be made by (name of institution)

University of Pretoria

Title

Initials

Surname

Department/ Unit

Telephone number (work)

+27 12

Fax number (work)

+27 12

E-mail

Information Specialist name

Course Information

Copies to be made for:
(Please indicate total amount of copies needed)

		Amount
	Single item handout
	Course pack
	Library's short loan collection
	Transient electronic copy

Course of Study

Academic Year

Enrolment fee for specific course:

Details of BOOK from which the copies are to be made

Full title of book

Name(s) of author/s of book

Name(s) of editor/s of book

Name(s) of compiler/s of book

ISBN

Publisher of book (as it appears on the imprint page)

Address of publisher (as it appears on the imprint page)

Title of chapter or extract to be copied

Name(s) of author(s) of chapter to be copied (in the case of a book which is edited or compiled)

Number of pages of the chapter or extract

From page to page
Total of pages:

Total number of pages of the book as printed

Please keep a printed copy of this application form for your own record.

Inquiries: Annah Molefe
Tel.: +27 12 420 4191 Fax: +27 12 362 5100