University of Virginia Press: Examination Copy Request Form

Examination Copy Request Form

Examination copies of most paperbacks are available to course instructors for a prepaid fee of $5.00 including shipping (see below). To receive an examination copy, please print out and complete the following form.

If ordering a paperback, please fill out this section and enclose check or credit card information. If ordering hardcover only, skip to title section below.

Prepayment of $5.00 for each book is required. Check, money order, or VISA/Master Card accepted.

Method of payment: _____Check/money order enclosed
Charge my: _____VISA _____MasterCard

Card No. __________________________________________
Exp. date______________

Signature ___________________________________________________

Title & author of book requested____________________________________________________

_____________________________________________________________________________

Name_________________________________________________________________________

Street_________________________________________________________________________

City______________________________________ State______________ Zip_______________

E-mail Address___________________________________________________________________

Signature_________________________________Name of course_________________________

Office telephone no._________________________ Semester & year________________________

Office hours_______________________________ Expected enrollment_____________________

Book is being considered as _____Required reading _____Supplemental reading

Name of college or university bookstore________________________________________________

Bookstore telephone no.__________________________________

Return form to:
Sales Department
University of Virginia Press
Box 400318
Charlottesville, VA 22904-4318
434-924-6064 / fax: 434-982-2655

Last Modified: 2/14/06