Blackwell

Contact Information

Name*:

Email*:

Library account code (if known—supplied by Blackwell):

Institute*:

Library*:

Address*:

Address 2:

City*:

State/Province:

ZIP/Postal code*:

Country*:

Professional Information

Select all that apply to you. I am*:

a Blackwell approval customer
interested in receiving forms/slips from Blackwell
interested in ordering from Blackwell-US
interested in ordering from Blackwell-UK
interested in record export services
interested in standing order services

Acquisition system:

Account Administrator

Please identify an individual at your library who will be responsible for setting up access and system privileges for others at your library.

Name*:

Title*:

Telephone*:

Email*:

Account Technical-Contact

Please also identify an individual at your library whom we can contact regarding use of Collection Manager at your library.

Name:

Telephone:

Email:

Additional Information

Please provide any additional information you feel will be valuable as we prepare your Collection Manager registration: