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Registration (Library members only)
To join the library, please fill in, PRINT OUT, sign and date this form and return it to the library. Please type in the details on screen before printing out the form.

When the library receives this form, a confirmation email will be sent to the email address given on this form.

Please Note:
Borrowers are responsible for all materials loaned in their names.
Borrowers who do not return material will receive an invoice for the cost of replacement plus service fee.

Title: Dr Mr Mrs Ms Miss Prof. Other
Surname:

Occupation/Position:
(registrar, student)
Department/ Organisation: MUDO (CERA) MUDOL School of Audiology
Other:
Email Address:
Length of Contract/Finishing Date:
     
Work Address: (if not located at RVEEH)  
Street:  
Suburb:
State:  
Postcode:  
Pager No:
Fax:
   
Home Address:
Street:
Suburb:
State:
Postcode:
Telephone:
Fax:
 

Signature:_____________________________ Date: _____________________

Please return this form to:
The Ronald Lowe Library, The Royal Victorian Eye & Ear Hospital
Locked Bag 8, East Melbourne VIC 8002, Australia

Fax: +61 03 9639 1808

OFFICE USE ONLY: RANZCO: Y / N Borrower Type:
Charge Rate: Borrower ID number:

 

 
Last Updated: 2 March, 2010    Increase text size Decrease text size Reset to default size  |   Disclaimer & Copyright  |  Site Map  |  Contact Us 
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