CAMIO® Order

*Required

Type of order

*Please indicate type of order

Complete Group Member information below.

Your Information
Contact

First, Last

e.g., Librarian, Director

Address

Technical Contact Information (if different from above)
Contact

First, Last

e.g., Librarian, Director

Address
Group Member Information (complete ONLY if Group Order)
Member Name/Institution
Symbol
(if applicable)
Contact Name
Population
E-mail
IP Address

Internet IP Address Information

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

Authorizations

We will create an authorization number and password for your access to CAMIO. Please complete the following:

Authorizations

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

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