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__________________________