Course Materials Request Form UCSD Authorized Personnel Only
Student Response Systems information (i>Clicker)
* = Required Fields
Instructor/Course Information
Term:* Fall Winter Spring Summer 1 Summer 2
Course No:*
Est. Enrollment:*
Instructor Name:*
Requestor First Name:*
Instructor Email:*
Requestor Last Name:*
Campus Phone:*
Requestor Email:*
For University Extension Courses Only
Course Section I.D.:
Start Date:
End Date:
Special Circumstances
No Text Required Material at A.S. Soft Reserves Material at Groundwork Books
Material at A.S. Soft Reserves and Material at Groundwork Books Other (use Comment box below)
Book Information
Edition & Publisher:
ISBN: Required Recommended
MyReader Custom Publishing Service
Title of Course Material:
Source of Original:
Faculty will provide Bookstore has a copy on file from a previous quarter
Materials are:
Same New Revised
If this form does not meet your needs, you may submit it again with additional information, email your order, or call (858) 534-6393.