OBSOLETE TEXTBOOK RETENTION REQUEST FORM
Please Note: Textbook Rental Services will not be able to secure additional copies in the
future of any obsolete or out-of-print textbooks. This retention request applies only to the
number of copies currently in inventory.
Number:
___________________________________ (Textbook Rental Use Only)
ISBN:
__________________________________ (13 digit)
Title:
_______________________________________________________________________
Author:
__________________________________ (Last Name)
Edition:
__________________________________
Copyright:
__________________________________
Out of Print:
_______________________ (yes or no)
Year Purchased:
_______________________
Publisher:
____________________________________________
The title listed above will be used for the following term(s) and course(s):
Term(s) Used:
Fall _____
J-Term _____
Spring _____
Department:
_______________________ (3-letter abbreviation)
Course:
_______________________ (3-digit number)
Type of Course:
New _____
Existing _____
Type of Instructor:
New _____
Existing _____
Type of Textbook:
Primary _____
Multiple _____
Summer _____
Total Course Capacity _______________________ (includes all sections)
Instructor Name:
_________________________ Email: _______________________________ Ext: _________
ADA Name:
_________________________ Email: _______________________________ Ext: _________
Chair Signature:
_________________________ Email: _______________________________ Ext: _________