Custom e-Book to Go Request Form

1. Please fill in the following information.

First Name *This question is required.

Last Name *This question is required.

Email Address *This question is required.

Phone *This question is required.

Institution *This question is required.

Department *This question is required.

Class Start Date *This question is required.

Course Enrollment *This question is required.

2. Please provide the full title and author and/or ISBN of the e-Book to Go you wish to customize. *This question is required.

Customization Options (you may select one or both options):

3. Please select how you would like to customize the e-Book to Go:

I would like to remove chapters.

(Note: For the first five chapters removed, the price of the e-Book will be reduced $1.50 per chapter, to a maximum reduction of $7.50 off the net price. While more than five chapters may be removed, the discount will not exceed $7.50.)
I would like to add up to 20 pages of my own content.

(Note: Content must be a single PDF file with an 8.5" x 11" trim size. Content cannot include materials that require copyright clearance or permissions; traditional academic Fair Use does not apply. Content will not be proofread or formatted and will appear exactly as it is received.)

Which chapters from the selected book do you wish to remove?

If your content is ready and in a single PDF file, you may attach it now.

4. If you have any questions or have additional details you'd like to include, please let us know: