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Online Order

[or Phone] [or Mail/Fax]

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. Course Material Questions

Is this REQUIRED course material?	Yes No
Is this the ONLY REQUIRED course material?	Yes No
If "No", what else are you asking students to purchase (e.g. - books, CDs, textbooks, simulation exercises, etc.)? Please include title, publisher, ISBN, and any additional ordering information that you can provide. Why are we asking?
Would you like to save your students 10-20% off standard bookstore prices by having us exclusively source your books and other required materials as part of our new textbook adoption service? (learn more)	Yes No
If "Yes", fill out our textbook adoption form and email it to info@universityreaders.com.

3. Course Information, Enrollments & Desk Copies

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

Course Description (e.g. - Introduction to Management):

Course Instructor Name:

Course University:

Course for which Term?

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:

Select the Date Course Materials are needed by

# of Desk Copies (use discretion):

Date Desk Copies needed by:

Select the Date Desk Copies are 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 in Step 2.
	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.
Print Student Online Purchasing Instructions

7. A Few Quick Marketing Questions

How Did You First Hear About Us?
If "other", please specify:
UR Representative or Referrer Name:

8. Recommend Our Service to Your Colleagues!

Name/Email - Referral #1:
Name/Email - Referral #2:
Name/Email - Referral #3:
Learn about our Amazon.com referral program.

9. Reprint Process & 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 Publishing Agreement.

Print Student Online Purchasing Instructions

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