Exam Copy Request Form
You can mail, email, or fax this form.
Mail to:
Dalkey Archive Press
1805 S. Wright Street
MC-011
Champaign, IL 61820
Fax: (217) 244-9142
Your book:
Author_______________________________________________
Title ________________________________________________
is being considered for my course # ______ , which has the course title of: ______________________________________________________ This course is scheduled to begin on (calendar date or year and term)______ The estimated enrollment is______.
Name__________________________________________
Position________________________________________
School__________________________________________
Department______________________________________
School phone #___________________________________
Address_________________________________________
City, State, Zip___________________________________
e-mail____________________________________________
In case the title you are requesting is in the process of being reprinted, please provide your e-mail address and phone number so we are able to notify you about its availability in a timely manner.
e-mail ___________________________________________
Phone #_________________________________________
Is there a modern/contemporary novel or collection of short fiction you are interested in seeing back in print for use in a class that you currently teach? If so, which title(s)? _________________________________________________
_________________________________________________
_________________________________________________
What class would you use it in?_____________________________