SFU Document Solutions
Custom Courseware Order Form
Phone: 778.782.5533
Fax: 778.782.5368
Email: courseware@sfu.ca
Spring ____
Course ______________________ Section _______
Burnaby __ Harbour Centre __ Surrey __
Instructor______________________________________________
Contact number: _______________________
Summer ____
Fall ____
Enrollment ______________
Email: _________________________________
Author/Compiler
Title of Courseware:
Required _____
Optional _____
Repeat package? If yes, or partial repeat, please indicate the last semester it was used:
It is recommended that courseware be perfect bound. This will be the default binding unless otherwise
specified. If you would prefer a different kind of binding, please indicate on line below.
_____________________________________________________________________________________
Covers will be provided for each package produced but you may provide additional title pages, tables
of contents or indices if you wish. Please indicate on line below:
_____________________________________________________________________________________
Proof Required?
Yes _____
No _____
Agreement (please check the appropriate box):
 The material I have submitted contains copyrighted work. (If selected, please complete and
attach copyright worksheets.)
 I own the copyright for the materials or have a letter of permission to reprint (please attach).
 I certify that the materials I have submitted contain no copyrighted works.
Name/ Signature ___________________________________ Date__________________________