Please complete this order and submit to The Secretary, Kurrajong-Comleroy Historical Society, PO Box 174, Kurmond, NSW, 2757, Australia, for reprints of any past issue of The Millstone included on the Society's website. For each issue required identify the month and year issued (eg. Mar-Apr 2004, Jul-Aug 2007 etc) as well as the quantity of each required. To print the blank order form click here. (If space is insufficient print off additional forms).
Costs for each issue (black and white copies only, sorry) is $3.
For each order add $2 postage within Australia and $10 for overseas.
| Issue (month/year) |
Quantity |
Total Cost |
| |
|
$ |
| |
|
$ |
| |
|
$ |
| |
|
$ |
| |
|
$ |
| Total cost (including $2 postage within Australia and $10 for postage overseas): |
$ |
Cheques should be made payable to Kurrajong-Comleroy Historical Society and be included with this order.
- I/We declare that the above ordered issue(s) of The Millstone will be used for:
• Private research or study.
• For purposes other than private research or study.
(Cross out whichever is inapplicable).
- If the above ordered issue(s) of The Millstone are required for purposes other than for private research and study then I/we have completed the Permission Request obtained by clicking here and will submit this with my/our order.
- I/We understand and agree to the following conditions with respect to the use of any material contained in any issue ordered:
• Compliance with the requirements of the Copyright Act 1969 (Cwlth) is my/our responsibility and the Kurrajong-Comleroy Historical Society will not be held liable for any breach by me/us under this Act regarding use of any material obtained in this order; and
• The Society endeavours to ensure that the information published in The Millstone is accurate however it cannot guarantee this and users are advised to rely upon their own verification for accuracy if and as required.
Signed ....................................................................... Date ..............................................
Print name(s) ..........................................................................................................................
Postal address .........................................................................................................................
Telephone .................................................. Email .............................................................
