Preassigned Control Number Application

Instructions	* indicates required field

Data entered in these blocks must match the title page exactly:

Title:		*
Subtitle:
Edition:
Publisher:		*
U.S. City:	State:	*

First 3 authors appearing on the title page. Do not include terms of address or affiliations:

	Enter the fullest form of the first author's name:

	Last name:	First:	Middle:

	Enter first author (personal or corporate) exactly as it will appear on the title page:


	Enter second author (personal or corporate) exactly as it will appear on the title page:


	Enter third author (personal or corporate) exactly as it will appear on the title page:


First 3 editors appearing on the title page. Do not include terms of address or affiliations:

	Enter first editor exactly as it will appear on the title page:


	Enter second editor exactly as it will appear on the title page:


	Enter third editor exactly as it will appear on the title page:

Will title appear at periodic intervals (annually, quarterly, etc.): Yes No
Approximate number of pages:	*

If title will consist of more than one physical volume, total number of volumes planned is:
This application is for volume number(s):

Primary language of text, if other than English:

Is this title intended for children or young adults?	Yes No

If title belongs to a series, the exact series title that will appear in the book is:

Series number, exactly as it will appear in the book:


Additional series

Person completing this application:
Projected publication date: Month: Year: *

Email address to which PCN data should be sent: *


Name:	*
Phone:	( ) *	Fax: ( )
Email:	*

Person who will send a copy of this book to the CIP Division immediately upon publication:

Name:	*
Phone:	( ) *	Fax: ( )
Email:	*

Comments: