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Textbook Requisition Form

This page is for faculty/department secretary use only.

Please use separate forms for each course in each semester.

Please indicate if access codes are to be included with the text book.

Packaging or other instructions can be outlined in the comment box.

Copies of each textbook request will be forwarded to the department.

The deadlines for textbook submissions are as follows:
March 15 for Spring/Summer orders
May 15 for Fall orders
October 15 for January orders

Please note that the highlighted fields are required.

Cross-listed Department (if applicable) and Course #.

Department*	Course No.*	Section
Cross-listed Dept.	Cross-listed Course No.
Course Name*	Enrollment Cap*
Instructor*	Email Address*	Phone Number*
	NOTE: On submission of this form, an email will be sent to the email address provided, that will contain the details of this order for your own records.
Please check one:
Spring Session	Fall Term	Winter Term
Summer Session	Full Year	Other

Book 1

Title*	Author	Quantity*
ISBN # (10 or 13 digit)	Supplier/Publisher	Required Date*

Please select:
Required
Non-Required (optional)

Please select:
Hardcover
Paperback

Please select:
Used for a previous term
Use most recent edition

Please select:
Package
Access Code required with text

Book 2

Title	Author	Quantity
ISBN # (10 or 13 digit)	Supplier/Publisher	Required Date*

Please select:
Required
Non-Required (optional)

Please select:
Hardcover
Paperback

Please select:
Used for a previous term
Use most recent edition

Please select:
Package
Access Code required with text

Book 3

Title	Author	Quantity
ISBN # (10 or 13 digit)	Supplier/Publisher	Required Date*

Please select:
Required
Non-Required (optional)

Please select:
Hardcover
Paperback

Please select:
Used for a previous term
Use most recent edition

Please select:
Package
Access Code required with text

Book 4

Title	Author	Quantity
ISBN # (10 or 13 digit)	Supplier/Publisher	Required Date*

Please select:
Required
Non-Required (optional)

Please select:
Hardcover
Paperback

Please select:
Used for a previous term
Use most recent edition

Please select:
Package
Access Code required with text

Book 5

Title	Author	Quantity
ISBN # (10 or 13 digit)	Supplier/Publisher	Required Date*

Please select:
Required
Non-Required (optional)

Please select:
Hardcover
Paperback

Please select:
Used for a previous term
Use most recent edition

Please select:
Package
Access Code required with text

Book 6

Title	Author	Quantity
ISBN # (10 or 13 digit)	Supplier/Publisher	Required Date*

Please select:
Required
Non-Required (optional)

Please select:
Hardcover
Paperback

Please select:
Used for a previous term
Use most recent edition

Please select:
Package
Access Code required with text

Book 7

Title	Author	Quantity
ISBN # (10 or 13 digit)	Supplier/Publisher	Required Date*

Please select:
Required
Non-Required (optional)

Please select:
Hardcover
Paperback

Please select:
Used for a previous term
Use most recent edition

Please select:
Package
Access Code required with text

Book 8

Title	Author	Quantity
ISBN # (10 or 13 digit)	Supplier/Publisher	Required Date*

Please select:
Required
Non-Required (optional)

Please select:
Hardcover
Paperback

Please select:
Used for a previous term
Use most recent edition

Please select:
Package
Access Code required with text

Coursepack Request

Quantity

New adoption
Used last term (unchanged)
New material added/deleted

Special binding required, will contact with details

CPS Wireless Responder "Clicker" Adoption

Quantity

Will use for all sections
Only in section

I am a first-time user of this technology.

Comments
Please add any other relevant details here:

Please ensure your information is correct and:

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