UQL CYBERSCHOOL DATABASE SUBSCRIPTION / RENEWAL FORM

New Subscription or Renewal		New Subscription Renewal
Name of School	^*
Contact Person	^*
email	^*
Name of database	^*
School Order Number	^*
Price (include pro rata database pricing where applicable)	^*
Start Date	^*
End Date
Number of Licensed Concurrent Users (if applicable)
IP Range (if applicable)
Number of students enrolled (if applicable)
Licence agreement form faxed (if applicable)		Yes No
Special invoicing requirements
Any other notes
I confirm that the information above is true and complete. ^* I have read and accepted the University of Queensland Privacy Statement. ^* ^* indicates mandatory field.

	©2009 The University of Queensland, Brisbane Australia
	ABN 63 942 912 684
	CRICOS Provider Number: 00025B
	Authorised by: University Librarian
	Maintained by: UQ Library
	Last Updated: 17 July 2009.