Examination Copy Request Form

All paperbacks are available on 90 day approval to teachers wishing to evaluate them for course use.  Copies are invoiced on 90 day approval. The invoice is canceled if you return the book or provide proof of adoption within 90 days OR you may keep the book for personal use by paying the invoice.

 All fields with asterisks must be completed for your request to be considered.

I. Title Requested
*ISBN:     (must be 13 digit number)

II. Course Information
*Course Number:  
*Course Title:  
*Start Date:   (e.g. Fall 2005)
*Course enrollment:  
Text currently in use for this course:
Title Author
III. Mailing Information
*Instructor's Name:  
(unfortunately we cannot mail to your home address)
*Address 1:  
Address 2:
*State:   (Please include abbreviated State Code, e.g. VA)
*Phone: (Phone number should be xxx-xxx-xxxx)  
Faculty Webpage:  
Additional Comments: