MOSMAN LIBRARY LOCAL STUDIES
IMAGES COLLECTION ORDER FORM
Please print out this form, fill it in and post together with a cheque made payable to
MOSMAN MUNICIPAL COUNCIL for the total amount. Please post to:

Mosman Library
605 Military Road
Mosman NSW 2088

          

Name:

Print From

Postal Address:

 

State:

Postcode:

Country:

Phone:

Fax:

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I understand all images are copyright Mosman Library or other institutions as indicated, and may not be duplicated or used in any manner whatsoever, without the written permission of the copyright holder. All rights reserved. Unauthorised use or duplication is a violation of applicable laws.

Black and White
Image File Number
and Title:
Size
Number required
@Cost
inc GST
SubTotal

.

15 x 10cm (6 x 4")

.

$20.90

.

.

18 x 13cm (7 x 5")

.

$23.65

.

.

25 x 20cm (10 x 8")

.

$30.80

.

.

30 x 24cm (12 x 9.5")

.

$44.00

.

Sepia
Image File Number
and Title:
Size
Number required
@Cost
inc GST
SubTotal

.

15 x 10cm (6 x 4")

.

$25.85

.

.

18 x 13cm (7 x 5")

.

$30.25

.

.

25 x 20cm (10 x 8")

.

$40.70

.

.

30 x 24cm (12 x 9.5")

.

$60.50

.

TOTAL

$

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