Coursepack Request Form

You must fill out the following form completely for your request to be processed. If information is omitted on this form, our permissions editor will have to contact you via phone, fax, or email before your request can be processed, and this may result in delays.

Requester Information

Name:

Address, including zip code and country:

Telephone number:

Fax:

Email address:

Course Information

Professor/Instructor Name:

Institution:

Department:

Course Name and Number:

Semester:

Expected Enrollment:

University of Michigan Press (UMP) Book Information

Title of Book:

Author/Editor of Book:

ISBN (What is an ISBN?):

Year of Publication:

Page Number(s):

Comments/Additional Information

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Please review the information you have entered to make sure it is correct. When you are finished, click "Submit Request" to send us your Coursepack request.