UCSD MyReader Inquiry & Order Form
Coordinator: Sara Thoreson (858) 534-7963
* = Required Fields
Instructor/MyReader Information
Term:
Department:
Course No:
Est. Enrollment:
*Instructor's Name:  
*Email:
Phone:
Title of Reader: 
Materials Are: 
Number of Desk Copies Needed:
Print Specifications:  
Binding: 
Cover Type:
Type of Reader (if applicable):
Paginate MyReader:
Insert Table of Contents:
Additional Information
How will you submit your materials? (please check all that apply)

I will email the digital files of my materials to custom@ad.ucsd.edu
I will drop off hard copies of my materials to the UCSD Bookstore Textbook department.
Please pick up hard copies from me at my UCSD campus office.
Please obtain the source materials for MyReader from the UCSD Library.
I will mail hard copies of my materials to the UCSD Bookstore at my own expense.
Other:

The MyReader Service will work to obtain all necessary copyright permissions for materials included in your course reader.
We can notify you of the permission status and fees (if any) associated with each selection in order to obtain your approval
on the final content and pricing of your custom packet.

Yes, please contact me with final permission update before you go to print.
No, not necessary to contact me before you go to print.
Source List

Using the box below, provide a complete source list for all non-original materials in your packet so copyright permissions can be obtained. Bibliographic information of source materials should include specific information such as: title, author, publisher, year published, specific page numbers, etc. that will be used from each source you wish to include in your reader.

If you are including your own original materials please contact Sara Thoreson (858) 534-7963
    
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