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Get Reproduction Request Form - Ivaro

Y CONTACT PERSON ADDRESS TELEPHONE E-MAIL ADDRESS WEBSITE DATE OF REQUEST (DD/MM/YY) Instructions: Section 2 requires that you select the appropriate medium for the proposed reproduction and provide the relevant details requested. Complete the form by listing the images to be used in Section 3 and signing the declaration in section 4. SECTION 2 - MEDIUM SELECTION MEDIUM TYPE A PUBLICATION TYPE OF PUBLICATION PURPOSE OF PUBLICATION/PRODUCT Book Brochure / leaflet E-Book Magazine / Journal.

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