NOTE: All Parts of This Form (Where Specified) Must Be Completed. Forms Lacking Complete Information in Key Areas Cannot Process. - You Must Use a Separate Form for Each Dissertation You Order - Dissertations come unbound in shrink-wrap packaging. Cost for dissertations is $26.50 each, which must be paid at the time you come to the library to pick up your order(s). NOTE: All information in this section is required and must be filled in, except for Email Address, which, while optional, would be very helpful to us in contacting you about order questions and arrival notification. NAME: DEPT: PHONE: PLEASE SELECT ONE: Student Faculty Staff Other (Specify) IF OTHER: EMAIL ADDRESS: ADDRESS (HOUSE/APT. NO. & STREET): CITY: STATE:     ZIP CODE: Please fill in as much of the following as you can (note that Title is required. The more information you can supply, the better--and the quicker for your order! AUTHOR: TITLE: ORDER NO.: NOT NEEDED AFTER: Please enter any additional information or comments here: Dissertations will arrive in 3-4 days. We will contact you by email first, then try by phone. When picking up items, you must pay by check or exact cash. Thank you for your cooperation. If you have any questions or need further assistance, please contact the Assistant Librarian for Technical Services, Janice Poston, by email or telephone (502-585-7130).