* Name:
* E-mail:
* Phone:

* FILE TRANSFER:

Select One My Dissertation is posted on the DSPACE AT CORNELL WEBSITE I have e-mailed my Dissertation to Cornell Digital Print Services
(you can email pdf to digital@cornell.edu)

Color Pages Needed: No Yes (at 25 cents per color page)

If YES, list pages by PDF file page numbers (ex. 3, 12, 21)

• Two required unbound copies ($15 plus $0.05/page)

Delivery
Field office:
Field office contact:
Due date: (please allow 5 days)

• Additional hard-bound copies ($23.50/book plus $0.05/page)

Quantity:

Delivery (a $2.50 handling fee will be charged for each ship to address and shipping fees will be added for off campus delivery)

ADDRESS ONE:
Name:
Street:
City, Zip:

ADDRESS TWO:
Name:
Street:
City, Zip:

• Additional soft-bound copies ($0.05/page plus binding)

Quantity:
Binding: Select One Tape binding ($1.25) Plastic Coil ($2.50) GBC-plastic comb ($1.85)

Delivery (a $2.50 handling fee will be charged for each ship to address and shipping fees will be added for off campus delivery)

ADDRESS ONE:
Name:
Street:
City, Zip:

ADDRESS TWO:
Name:
Street:
City, Zip:

* Select One Mastercard VISA Discover Cornell Card
If Cornell Card (Bursar) , list Cornell Card Number

* If paying by credit card, after submitting this form, please call 607-255-2524. Leave your name, credit card number and expiration date on our secure voice mail. Thank you.