University Readers

1. Main Contact's Name & Address

Main Contact Name:
University:
Department:
Address Line 1:
Address Line 2:
City/State/Zip:
Email Address:
Phone/Phone 2:
Born on Month/Day?	I'm a New Client!
NOTE: Desk copies are shipped to the address above unless specified otherwise.

2. (Optional) Choose Content from University Readers Library BETA

NEW! University Readers Library BETA
Looking for additional content? Browse, preview and select pre-cleared, best-of-the-best content, specifically designed for custom publishing.
Now Featuring The Social Issues Collection: A Routledge/University Readers Custom Library for Teaching.

3. Course Information, Enrollments & Desk Copies

Course Name/# (e.g. - MGMT 160):

Course Description (e.g. - Finance):

Course Instructor Name:

Course University:

Course for which Term?

Is this REQUIRED reading?

Yes No

The ONLY REQUIRED reading?

Yes No

Is this course cross-listed?

Yes No

Cross-listed Course Name/#:

Have we previously produced this course pack? Yes No
If "yes," for which term did we previously produce it?
If "yes":
Changes (if applicable):

Estimated # of Pages:

(1 page = 1 side of a page)

Expected/Max Enrollment:

First Day of Class:

Date Course Materials needed by:

# of Desk Copies (use discretion):

Date Desk Copies needed by:

NOTE: We print Course Name/#/Description/Instructor/University/Term on covers.

4. Production Specifications

NEW: 100% Recycled Paper Option (add 1c/page): Yes - Go Green! No
Select Your Cover:
Format Specifications:
Print Specifications:
Paginate:
Binding Specifications:
TOC (Table of Contents):
Will Your Course Syllabus be Included? Yes No
Are there any materials NOT needing copyright clearance? Yes No
If yes, please specify (public domain, permission granted by the author, etc.) and supply us with any necessary documentation.
New: Plan on changing content if price is over a certain amount? Yes No
New: If "yes," at above what total amount should we contact you?
Additional Instructions:
Offer Code (if any):
NOTE: Depending on your specifications, pricing may vary. Please call for details.

5. Specify Your Materials Submission Method(s)

How will you submit your materials? (please check all that apply)
	I'm already in touch with my Account Manager regarding materials submission.
	I'll upload digital file(s) such as my Reading List Bibliography.
	I will email digital file(s) to you at materials@universityreaders.com.
	I'll mail hard copies FREE (FedEx me a physical Materials Submission Kit).
	I'll mail hard copies FREE (Email me a Materials Submission Kit - faster!).
	I'll mail hard copies at my own expense.
	I'm sending nothing. I use business cases (Harvard, Darden, Ivey, etc.) only.
	University Readers has all my files digitally stored from a previous term.
	Please contact me to arrange alternative submission of my materials.
NOTE: We leave intact margin notes on originals unless instructed to remove them.

6. Select a Student Distribution Method

Student Distribution Method:
PDF Download: specify articles to be included in your FREE 20% PDF download (may not exceed 20% of total page count).
*Students visit www.universityreaders.com/students to purchase materials online.

7. A Few Quick Marketing Questions

How Did You First Hear About Us?
If "other", please specify:
UR Representative or Referrer Name:
Recommend Our Service to Your Colleagues!
Name/Email - Referral #1:
Name/Email - Referral #2:
Name/Email - Referral #3:

Reprint Process & Publishing Agreement

Please click on the following links to read our Reprint Process and Publishing Agreement:
• Reprint Process To conserve paper and avoid overprinting, we will estimate a quantity needed according to our experience and your class enrollment. If we have underprinted, we have a very efficient 24-hour reprint-on-demand process. • University Readers' Publishing Agreement I authorize University Readers to produce and distribute a custom published work for my course(s) as listed on this order form and to secure all necessary copyright permissions based on the information and material submitted. If I have asked University Readers to not pursue reprint permission for any excerpts in my custom published work, then I warrant that I am the exclusive rightsholder of such material and therefore grant permission to University Readers for one-time use without charge, unless stipulated in writing and agreed to in advance by University Readers. For all other items, University Readers warrants that it will secure any required copyright permissions. I also understand that I am entering into an EXCLUSIVE publishing agreement, and therefore I agree not to allow or influence any company, institution, department, agency, person, or library to publish, print, copy, distribute, or post this custom published work or its content via print or digital mediums, INCLUDING ANY FORMAT OF ELECTRONIC RESERVES, for my students. University Readers will allow print copies to be put on physical library reserves for limited student use. I further indemnify University Readers against any liability if any of the foregoing information is inaccurate or incorrect and agree to act swiftly to remove or prevent any unauthorized distribution as stipulated in this agreement.
Yes, I fully understand and agree to all terms of the Reprint Process and Publishing Agreement.