Exam Copy Request Form

Please fill out all sections of this form and click Submit. Note that required information is marked with an asterisk (*).

Also note that we are UNABLE to deliver to a P.O. Box; however, we are able to deliver to a Campus Box. If you do not provide a physical address or campus box number, your request will not be deliverable.

 

1. Book Selection

 

By requesting an examination copy, I certify that the book will be considered for possible course adoption.

I would like to receive an examination copy of the following title(s):
PLEASE REQUEST NO MORE THAN THREE TITLES
PER MONTH

 

2. Information about you

 

Date:
(Maximum characters: 9)

E-mail:*
(Maximum characters: 30)

First Name:*
(Maximum characters: 30)

Last Name:*
(Maximum characters: 30)

Department:*
(Maximum characters: 30)

University:*
(Maximum characters: 30)

University Address:*
(Maximum characters: 30)

City:*
(Maximum characters: 30)

State:*
(Maximum characters: 2)

Zip:*
(Maximum characters: 9)

Country:
(Maximum characters: 30)

Work Phone:
(Maximum characters: 12)

Ext.:
(Maximum characters: 9)

Department Chair's Name:*
(Maximum characters: 30)

Department Chair's Phone:*
(Maximum characters: 12)

Ext.:
(Maximum characters: 9)

 

3. Course Description

 

Course Name:*
(Maximum characters: 30)

Course Number:*
(Maximum characters: 30)

Class Starts:*
(Maximum characters: 9)

Est. Enrollment per Year:*
(Maximum characters: 5)

Title & Author of Current Textbook:*
(Maximum characters: 30)

 

4. Comments

 

 

5. Submit

 

Free shipping of examination copies is available only within the United States and its territories. To obtain the charges for other addresses, please click on the feedback button and e-mail your address and the titles of the books you wish to receive. We will advise you of the shipping charges via e-mail.

PLEASE, CLICK "SUBMIT" ONLY ONCE!!
Your order is being processed. You will be automatically redirected to a confirmation page when your order is complete.
PLEASE, CLICK "SUBMIT" ONLY ONCE!!