DOCLIS Registration Form - Staff

Brush Farm Corrective Services Academy Library Fax: (02) 9804 5460

To register with DOCLIS you must comply with the Copyright Act of 1968 by sending in a SIGNED hard copy of this completed form to your librarian by FAX or posting to Brush Farm Corrective Services Academy Cnr Terry & Marsden Rds Eastwood NSW 2122 Australia. The information can then also be submitted electronically for speed of processing.

To enable us to contact you when necessary, please complete as many fields as possible. You should receive your personal identification logon details and relevant information within a few days.

Complete your contact details

Surname:

First Name:

Location:

Section:

Position:

ID Number:

Email:

Work Phone:

Pager:

Fax:

Work Address:

Home Address:

Home Phone:

Mobile:

Employment details

Permanent Casual Contract Temporary

Commence Date:

Finish Date:

Copyright Declaration

All copies requested by me under this agreement are required for the purpose of research or study, will not be used for any other purpose, and have not previously been supplied to me by the Library. The Library may treat as signed by me any email request and declaration made under subsection 49(1) of the Act that bears my username and ID number, and that records that it was sent from my email address. I understand that it is an offence under section 203F of the Act to make a declaration under section 49 that I know, or ought reasonably to know, is false or misleading in a material particular, and I will not allow any request to be signed in the manner above without my authority. I undertake to keep my ID number confidential

Privacy Notice

The personal information collected by the Library includes the information provided by you on this form; any transactional information based on your borrowing and information you may provide from time to time. The Library may use your information to keep you informed about items which may be of special interest to you. The Library may also use your information for planning, research, marketing and service development. The Library will take all reasonable steps to ensure your personal information is protected from unauthorised access, misuse, modification and disclosure while stored or transmitted by us. Each User is assigned personal identification logon details to access online Library services.

PLEASE READ CAREFULLY

(Conditions to be agreed to prior to registration)

1. I understand that I am responsible for all items borrowed in my name and undertake not to lend these to others.

2. I accept that all items borrowed are on loan for the specified period marked on the item and an extension of loan is only available on request to and approval from the library.

3. I acknowledge that it will be my responsibility to return the items borrowed in my name to the library and should I fail to do so, I undertake to cover the replacement cost of those items.

4. I will pay the replacement cost of all lost items that I borrow from the Library. The amount paid will be the current replacement cost of the item. If replacement is not available (because of it being out of print etc) a standard charge of $50.00 per item will be paid.

5. I agree that my replacement costs outstanding from my use of the agencies library facilities at the time of my leaving the Department may be recovered from any monies payable to me by the agency.

6. In case of disputed returns, I will provide to the Library a completed NSW Statutory Declaration Form detailing when and under what circumstances the item was returned to the Library.

7. I will notify the library within 10 working days of any change of my work or home contact details.