ANSI/NISO Z39.43-1993	STANDARD ADDRESS NUMBER--UNITED STATES AGENCY International Standard Numbering System for the Information Industry 630 Central Avenue, New Providence, New Jersey 07974     Email: isbn-san@bowker.com FAX: 908-219-0188
	R.R. Bowker LLC, a Cambridge Information Group company

Please assign a SAN to the following address:


STORE OR COMPANY NAME:  ________________________________________________________

ADDRESS:       _________________________________________________________________

________________________________________________________________________________

CITY:  ____________________   STATE:  ___________  

COUNTRY:______________________   ZIP:  _______________________

PHONE NUMBER:  _____________________  FAX NUMBER:  _____________________________

E-MAIL:  ______________________  WEB SITE:  ____________________________________

FAX-ON-DEMAND:  _______________  TOLL-FREE FAX:  _______________________________

CONTACT NAME:  _________________________________________________________________

TITLE: _________________________________________________________________________

ISBN (if applicable): __________________________________________________________


TYPE OF BUSINESS:  (Please check one)


____________	Bookstore            ____________   Publisher

____________	Book Distributor     ____________   Library

____________	Book Wholesaler      

____________	Other, Please clarify:   ________________________________________

_________________________________________________________________________________


PAYMENT: When submitting this print application, a $20 surcharge will be added to the total fee.  
Please note that there is no surcharge if you choose to submit your application electronically.  
If you wish to submit an electronic application, please go to www.isbn.org, and select the secure server.



 A Non-Refundable One Time Service Charge of $150 Per SAN For Each Assignment

Express Processing Surcharge Per SAN $75 
Priority Processing Surcharge Per SAN $25
(Service charge fees are subject to change)

__ Check/Money Order enclosed.   Make payable to "R. R. Bowker."

__ Charge:  ____ American Express   ____ Visa   ____ Master Card   ____ Discover

Card Holder Name: ______________________________________________________________

       Account #: __________________________ Expiration Date: __________________

Manual Processing Fee: $20.00
SAN Service Charge: $150.00

Express Processing Surcharge     $________________

Priority Processing Surcharge	 $________________

Total amount enclosed or charged:$________________ 

* Note: Bowker does not charge Sales Tax


Our Company hereby applies to the ISBN/SAN U.S. Agency for a SAN Assignment

Authorized signature: __________________________________________________________

Title: _________________________________________       Date: ___________________

Processing Information:
  
Your application for a SAN Assignment will be processed ONLY if you include the following:

1. Completed application
2. Payment

Processing time for a SAN application is 15 full business days from the date 
of receipt (provided there are no problems with the application).

Express Processing:
    
Express processing includes a return within 24 business hours by e-mail ONLY 
(providing there are no problems with the application).

Express service applicants MUST provide an e-mail for delivery of SAN.

	Contact e-mail:	_________________________________________________________

Priority Processing:
  
Priority processing includes a return within 72 business hours of receipt 
(provided there are no problems with the application).

_______________________________________________________________________________ 

     NAME:  ________________________________________________    

  ADDRESS:  ________________________________________________    

            ________________________________________________    


  [  ] Ship to  [  ] Bill to  [  ] Warehouse  [  ]  Returns     

  [  ] Other (Specify):  ___________________________________    

      SAN:  ________________________________________________    
                                                                
_______________________________________________________________________________



_______________________________________________________________________________

     NAME:  ________________________________________________    

  ADDRESS:  ________________________________________________    

            ________________________________________________    


  [  ] Ship to  [  ] Bill to  [  ] Warehouse  [  ]  Returns     

  [  ] Other (Specify):  ___________________________________    

      SAN:  ________________________________________________    
                                                                
_______________________________________________________________________________



_______________________________________________________________________________

     NAME:  ________________________________________________    

  ADDRESS:  ________________________________________________    

            ________________________________________________    


  [  ] Ship to  [  ] Bill to  [  ] Warehouse  [  ]  Returns     

  [  ] Other (Specify):  ___________________________________    

      SAN:  ________________________________________________    
                                                                
_______________________________________________________________________________