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Home > Services > Set of forms > Form 23 - AUTHORIZATION TO THE REPRODUCTION FOR STUDY REASONS

Form 23 - AUTHORIZATION TO THE REPRODUCTION FOR STUDY REASONS

To the Director of the Palatine Library of Parma

Piazzale Pilotta, 3
43100 Parma

The starred(*) fields are compulsory

Authorization to the reproduction for study reasons

Applicant

ID

Living in

Postal Code

Street

Street number

Telephone

Fax

E-mail

Payment method

Cataloging

Author

Title

Release place and date

Pages or sheets

Kind of reproduction

Photocopy

Positive microfilm

Negative microfilm

Photocopy from microfilm A4 size (label)

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Photocopy from microfilm A3 size (label)

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Black and white print A4 size (label)

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Black and white print A3 size (label)

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Ful-colour print A4 size (label)

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Full-colour print A3 size (label)

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Digitizing on CD-ROM (label)

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Digitizing on CD-ROM from b/w microfilm (label)

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Digitizing on CD-ROM from DIA (label)

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Copy on CD-ROM from existing CD (label)

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Responsibility acceptance declaration:

Declaration

Declaration of regulations knowledge

I campi in grassetto sono obbligatori

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pagina creata il 10/03/2009, ultima modifica 24/09/2014