Course Material Order Form

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Course Material Order Form

Date Ordered (MM-DD-YYYY):

Date Needed for Students (MM-DD-YYYY):

Contact Name:

Phone Number (###-###-####):

Email:

Department:

Course Number: Course Name:

Professor:


Number of Packets needed:

Will this course packet be available online? Yes No

Is this required course material? Yes No

Return originals and complimentary copy to:

Location:

# complimentary copies:


COPY INSTRUCTIONS: 1 Sided 2 Sided As per sample

BINDERY INSTRUCTIONS:
Spiral Binding 3-Hole Drill No Binding or Holes
Side Staple Corner Staple No Staple

DISTRIBUTION: Please notify your students
Health Sciences Bookstore University Campus Store In Class Sales

SPECIAL INSTRUCTIONS:


USER AGREEMENT:

This packet does not violate university copyright policy.
(By submitting this form you agree that this packet is not in direct violation of university copyright policy.)


COPYRIGHT CLEARANCE

Please select one of the following options. If you are uncertain or have questions, please direct them to Steve Beck at steve.beck@utah.edu.

I have my copyright clearance information ready to upload.
I don't have my copyright clearance information ready. Please provide me with a form.
My submission does not require copyright clearance.