IET and SciTech Examination Copy Request Form



 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:  
Decision Date:  
Text currently in use for this course:
Title Author

III. Mailing Information
*Instructor's Name:  
*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: