Kentucky State FALL 2017 Book Request Form

Please use this form to submit your content requests for the FALL 2017 term.

Note that you will need to complete this form once per book, and you'll need to repeat this process for each unique course section you are teaching.

If you would like a copy of your request emailed to you for your records, please check the "Send me a copy of my responses" option at the bottom of this form.


Today's date






Alphanumeric code identifying your course, such as "ACC 201 01"




Your first and last name







Please enter number only (no additional identifiers), and please exclude dashes


Please provide as much information as possible to help us fulfill your request.


Please provide as much information as possible to help us fulfill your request.


Please provide as much information as possible to help us fulfill your request.


Please provide as much information as possible to help us fulfill your request.






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