Harlan Davidson, Inc.

Examination Copy Request Form
If you would like to examine a textbook for adoption, please fill out the request form below. Please limit your request to no more than 3 titles.

Note: This form is not for respondents in the United Kingdom or Continental Europe; please see distributor (Gazelle, Inc.) on Customer Service page of this site.

Title Information:
Title:
ISBN:
Check here if you have already adopted this book as required reading for a course and need a desk copy.

Course Information:
Course Title:
Course Number: Start Date: Level:
Enrollment: How frequently is this course offered?
Current Textbook:
Adoption Deadline:

Shipping Information:
Your Name (including title):
Department:
School:
Street Address (for UPS shipping):
City / State / Zip Code:
Telephone Number (including area code):
Email address:
Verify:
Is this request in response to our catalog? yes no

If all information has been provided, and you qualify for a complimentary copy, you can expect to receive your book(s) in approximately 10 days. (We will notify you if we cannot ship a complimentary copy to you.)

You may also print this form and fax to (847) 541-9830, attention "Textbook Coordinator";
or mail to

Textbook Coordinator
Harlan Davidson, Inc.
773 Glenn Ave
Wheeling, IL , 60090-6000.

To reach the Sales Office, please email harlandavidson@harlandavidson.com, or phone (847) 541-9720.