UNIVERSITY OF PITTSBURGH \ FORM  INSTRUCTION GUIDE



FORM TITLE:         COURSEPACK REQUEST FORM
NUMBER:             FORM CCC 0002
PROCEDURE:          05-05-01


                TO BE COMPLETED BY THE REQUESTER
         (Use a separate sheet for each course number)

Course Information

1.   Date of the request (MM/DD/YY).

2.   Date when the term begins (MM/DD/YY).

3.   University of Pittsburgh.

4.   Subject abbreviation.

5.   Four-digit  course  number and five-digit  course  reference
     number.  If unknown, refer to the Schedule of Classes of the
     appropriate term.

6.   Name of the course instructor.



Information About Material to be Reproduced

7.   Out  of  print  title?  (Yes or No - Circle the  appropriate
     answer)

8.   Indicate whether additional information is attached  to  the
     Coursepack   Request  Form.   (Yes  or  No  -   Circle   the
     appropriate answer)

9.   ISBN/ISSN - International Standard Book Number/International
     Standard Serial Number.

10.  Author, editor, or translator.  The instructor's name if the
     text is an original work by the instructor, or combined with
     copyrighted  material.   The name of  the  original  author,
     editor, or translator if solely copyrighted material.

11.  Name of the publisher or copyright holder.

12.  Complete title of the work,  The course title if the text is
     an  original  work  by  the  instructor,  or  combined  with
     copyrighted  material.   The  original  title,   if   solely
     copyrighted material.Title of the book or journal.

13.  The title of the chapter or article to be reproduced.

14.  The author of the chapter or article to be reproduced.

15.  Total number of pages to be reproduced.

16.  Indicate the page number of the first page to be reproduced.

17.  Indicate the page number of the last page to be reproduced.

18.  Copyright  year (2 digits), e.g. 1993 would  be  written  as
     '93.

19.  Publication year (if different than the copyright year).

20.  Volume number.

21.  Edition number.



TO BE COMPLETED BY THE BOOK CENTER

22.  Document reference number assigned by Book Center.

23.  Purchase Order number assigned by the Book Center.

24.  Line item reference number assigned by the Book Center.

25.  Copyright Clearance Center account number.

26.  The Book Center, University of Pittsburgh.

27.  Name of individual to contact in case of questions.

28.  The Book Center address.

29.  City, state, and zip code.

30.  Telephone number (including area code).

31.  Telefax number (including area code).

32.  Number  of  sets requested.  To be determined from  previous
     enrollments in the course.