Local Studies Donation Form
Your Name
First Name
Last Name
Your Email
example@example.com
Your Phone Number
Your Address
Street Address
Street Address Line 2
City
State
Postcode
Are you a member of Goulburn Mulwaree Library?
Yes
No
Please describe the material(s) you wish to donate to Goulburn Mulwaree Library.
Please indicate the type of material(s) you wish to donate
Photographs / negatives / slides
Unpublished documents
Published books / reports etc.
Maps
Films / videos
Objects
Other
Please indicate the approximate age of the material(s) you wish to donate
Please indicate the condition of the material(s) you wish to donate
How are the material(s) related to the Goulburn Mulwaree area?
Please attach a photo of the material(s)
Browse Files
Drag and drop files here
Choose a file
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of
Are you donating originals or copies?
Original
Copy
I would like the Library to make a copy of my original material
Unsure
Did you create the material(s)?
Yes
No
Unsure
Are you willing to transfer ownership of the material to the Library?
Yes
No
Unsure
Are you willing to assign Copyright ownership to Goulburn Mulwaree Library?
Yes
No
Unsure
Are you willing to have the material made public on the Library's website and/or catalogue, and/or viewable to Library visitors?
Yes
No
Unsure
Submit
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