Bookstore Quote & Order Form

Bookstore Quote & Order Form
After you submit this form:
1. We will email a quote to the bookstore contact and cc the faculty contact.
2. Once we receive a purchase order, we will email the bookstore contact a PDF containing unique, single-use access codes and student redemption instructions, typically within two business days.
3. We will send an invoice based on your purchase order to the bookstore contact.
Bookstore Contact Name*
Bookstore Contact Email Address*
Faculty Contact Name for Cohort*
Faculty Contact Email*
This faculty will be advised of upcoming expiration dates
College/University*
Program Type
Number of Students Needing Access*
Subscription Length*
Does your program purchase ICE Videos?*
Products for student purchase*

DocuLearn
Products for student purchase*

DocuLearnICE Video Courses (StrokeHelp)
Products for student purchase*

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
Terms of Use*

I agree to the Terms of Use on the ICE Learning Center website: www.icelearningcenter.com/terms-of-useI understand that if no Start Date is provided, the subscription will begin when the first student redeems their access code through the ICE website.
Signature

Clear
Date

MonthDayYear
Date
Should be Empty: