Examination Request Form

Help us help you by filling out this brief survey about your program and examination needs. Restrictions apply: please read our examination policy for more information. Free sample lessons, audio and multimedia demos, and journal reviews are also available online.

Name: *

Position:

School/District:

Email: *

Please use your school email address.

Phone: *

Course Name(s):

Grades of Program:

(i.e. K-6, 9-12, college, etc.)

Size of Annual Enrollment:

Deadline for Adoption Decision:

Products of Interest (i.e. the titles or type of materials you are interested in reviewing): *

How did you find out about this product(s)?:

Are you ready to secure your examination copies now?:

Yes

A company reprentative will contact you regarding the above within 1-2 business days.

If you selected yes...

See examination policy for more information.

If yes, how would you like to examine these materials? (We accept VISA and Mastercard only):

Borrow

Buy at Discount NOTE: select titles are available with this option; review our policy

Shipping Address:

The address at which you want to receive the materials.

Billing Address:

The billing address for the credit card you will be using to complete your order. What's this?

Have you ordered from us before? If so, may we use the credit card on file?:

Yes

Comments: