Campus Store instructor textbook request form

Revised 10/6/20009

For use by instructors or designated departmental contacts ONLY, please.

Dietetic Internship Graduate Sciences (medical, non-MD) Human Investigation Program Medical Informatics Master in Public Health Medical Technology Oregon Graduate Institute Paramedic OSU Pharmacy Program Physician Assistant Radiation Therapy School of Dentistry--DS1 School of Dentistry--DS2 School of Dentistry--DS3 School of Dentistry--DS4 School of Medicine--1st year School of Medicine--2nd year School of Medicine--3rd & 4th years School of Nursing--Accelerated Baccelariate School of Nursing--OCNE School of Nursing--Rn/Bsn School of Nursing--Graduate

(Just highlight with your mouse the program you are ordering for.)

Course #:

Course title:

Term/Start date:

Instructor:

Contact person if not the instructor:

E-Mail: Mail code: Phone:

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Please order ALL the textbooks you need for this class. Please indicate the following for each title:

Anticipated number of books needed:

ISBN (if known):

Author:

Title:

Please indicate one of the following:

Required?:

Recommended?:

Any other information you think We need:

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Anticipated number of books needed:

ISBN (if known):

Author:

Title:

Please indicate one of the following:

Required?:

Recommended?:

Any other information you think We need:

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Anticipated number of books needed:

ISBN (if known):

Author:

Title:

Please indicate one of the following:

Required?:

Recommended?:

Any other information you think We need:

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Anticipated number of books needed:

ISBN (if known):

Author:

Title:

Please indicate one of the following:

Required?:

Recommended?:

Any other information you think We need:

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Anticipated number of books needed:

ISBN (if known):

Author:

Title:

Please indicate one of the following:

Required?:

Recommended?:

Any other information you think We need:

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Anticipated number of books needed:

ISBN (if known):

Author:

Title:

Please indicate one of the following:

Required?:

Recommended?:

Any other information you think We need:

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Anticipated number of books needed:

ISBN (if known):

Author:

Title:

Please indicate one of the following:

Required?:

Recommended?:

Any other information you think We need:

---

Anticipated number of books needed:

ISBN (if known):

Author:

Title:

Please indicate one of the following:

Required?:

Recommended?:

Any other information you think We need:

---

Anticipated number of books needed:

ISBN (if known):

Author:

Title:

Please indicate one of the following:

Required?:

Recommended?:

Any other information you think We need:

---

Anticipated number of books needed:

ISBN (if known):

Author:

Title:

Please indicate one of the following:

Required?:

Recommended?:

Any other information you think We need:

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Any comments or questions?

If so, please enter them here:

This will reset ALL your options to the blank default. If you want to only change specific items, please use the scroll tabs and Shift+Tab to go back through them.

We will send you a message confirming receipt of your order. If you do not receive the confirmation back, the order may not have been received.

Done?

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Return to the Store main page.

Return to the list of Course books

Go to the Student Center page.

Goto University's main page.

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by acad@ohsu.edu