ArchiveGrid Order

Type of order

*Please indicate type of order

Individual institution order
Group order (Complete Group Member information below.)

Your Information

Contact

*Institution Name

OCLC Symbol

Directory of OCLC Libraries.

*Contact Name

First, Last

JobTitle

e.g., Librarian, Director

*Phone Number

*E-mail

Address

*Address 1

Address 2

*City

State or Province

*ZIP or Postal Code

Technical Contact Information (if different from above)

Contact

Technical Contact Name

First, Last

JobTitle

e.g., Librarian, Director

Phone Number

E-mail

Address

City

State or Province

ZIP or Postal Code

Group Member Information (complete ONLY if Group Order)

Member Name/Institution	Symbol (if applicable)	Contact Name	Phone	E-mail	IP Address

Internet IP Address Information

I want to connect to ArchiveGrid using the following IP addresses:

IP Address	IP Address	IP Address

Authorizations

Printable version of the ArchiveGrid Terms and Conditions (opens in a new window)

*Do you affirm that you are authorized to submit this order form and thereby order ArchiveGrid on behalf of the institution, and do you agree to the ArchiveGrid Terms and Conditions?

Yes
No

*Your Name

*Your E-mail

Your Title

Comments

ArchiveGrid Order

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