ESL CD-ROM Online Site License Agreement FORM

To establish your license, print this form, complete it, and mail or fax the original to:

University of Michigan Press ESL
Site Licenses
ATTN: ESL Department
839 Greene Street
Ann Arbor, MI 48104-3209
Fax: 734-615-1540

If you have any questions regarding the Terms and Conditions, please write to esladmin@umich.edu or call 866-804-0002.

Site licenses are valid only through the editorial offices of the University of Michigan Press (not valid through Perseus Distribution).

Please check the product for which you are seeking a site license.

      Fish Trek

      Preposition Pinball and Other Games

You may only select one product per copy of the form.

You MUST already have purchased the CD-ROM to apply for a site license. Order online at www.press.umich.edu/esl/ or call 877-364-2942.

License Fees

     $35: 0-20 computers
     $45: 21-40 computers
     $55: 41-60 computers
     $70: 61-100 computers
     $100: more than 100 computers

Date of application:                                       

Note that the site license will always be in effect for one academic year, August 1 - July 31.

Date you wish license to be valid:                               

School:                                                                                        

Program:                                                                                      

Course Name (if relevant):

                                                                                               

Billing Address:

                                                                                               

                                                                                               

                                                                                               

                                                                                               

Billing Contact:

                                                                                               

Phone Number:

                                                                                               

Fax Number:

                                                                                               

Email:

                                                                                               

Method of Payment: (Sorry, we are currently only able to accept credit card payment for the licenses.)

           Visa, Mastercard, or American Express

Account Number:

                                                                                               

Expiration Date:

        /        

By this Agreement, The Regents of the University of Michigan, for the University of Michigan Press (UMP), grants a license subject to the terms and conditions set forth in Paragraphs 1 to 6 of Terms and Conditions, all of which are hereby agreed to between the UMP and the subscriber.

By signing below you certify that you have read and agree to all such Terms and Conditions listed. Your signature also certifies that you are authorized to sign this form on behalf of your institution.

Site license representative (type or print):

                                                                                               

Authorized Signature:

                                                                                               

Date:                                         

Title of authorized signer (type or print):

                                                                                               

Address (if different from "Bill to" address):

                                                                                               

                                                                                               

                                                                                               

Phone Number:

                                                                                               

Fax:

                                                                                               

Email: