Textbook Request

(Instructor copy)
FORMS DUE: Spring Semester-October 1 Fall Semester-March 1

Division:

Date:
*Required

Course Number:
*Required

Course Name:

Is text used for more than one course?:

Yes No

Course Number:

Course Name:

Course Number:

Course Name:

Course Number:

Course Name:

Semester Text Needed:

Instructor Name:

Instr Email:
*Required

SECTION I. REQUESTED ACTION
Requested Action:

SECTION II. TEXTBOOK PRESENTLY USED

Author:

Title:

Edition:

Publisher:

Date:

ISBN Number:

SECTION III. NEW TEXTBOOK REQUESTED

Author:

Title:

Edition:

Publisher:

Date:

ISBN Number:

This text is:

Hardback Paperback

Reason for requested change:

SECTION IV. NUMNBER NEEDED

Number of students enrolled int this course the last time taught:

Estimated number needed for semester:

Factors effecting estimated number of textbooks needed:

By clicking the Sign and Submit button I am electronically signing this form and understant that the form will be emailed to the Dean of Instruction for approval, then onto the Vice President for Academic & Student Affairs to electronically sign. After final approval the form will be emailed to the Bookstore for processing.