Bookstore Quote & Order Form

Bookstore Quote & Order Form
After you submit this form, we will send a quote to the email address(es) you provided.

Once we receive a purchase order, we will send you a PDF with unique, single-use discount codes (one per page) and instructions for students to redeem them, typically within two business days.

We will also create an invoice based on your purchase order and send it to the same email address(es).

If a student purchases through your bookstore, the bookstore can provide them with a single page of the PDF containing their code and instructions. Students redeem their codes in our online store at no additional charge and receive access within one business day.

Please note that student codes are nonrefundable, but they do not expire and can be used in future terms.
Your Name*
Your Email Address*
Email(s) for Quote/Invoice*
Separate multiple addresses with commas.
College/University*
Program Type
Faculty Contact Name for this order
Faculty Contact Email
This faculty will be advised of upcoming expiration dates
Number of Students Needing Access*
Subscription Length*
Products*

DocuLearnICE Video LibraryICE Video Courses (StrokeHelp)
Class or Cohort Name (if known)
Access Start Date for Students (if known)

MonthDayYear
Additional Comments or Questions (optional)
Terms of Use*

I agree to the Terms of Use on the ICE Learning Center website: www.icelearningcenter.com/terms-of-use
Signature

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Date

MonthDayYear
Date
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