Preassigned Control Number Application

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Instructions        * indicates required field

Section One: Title Page Information

Data entered in these blocks must match the title page exactly:
 
Title:     *
Subtitle:        
Edition:        
Publisher:     *
U.S. City:     State:   *

Section Two: Author Information

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:
 
 

Section Three: Volume Information

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)  
 
Will title appear at periodic intervals (annually, quarterly, etc.):    Yes     No  

 ISBN Converter  13-digit ISBN Policy Statement  
 
  Permanent  
  ISBNs for this title Qualifiers Paper  
1.  
2.  
3.  
4.  
 
Additional ISBNs

Section Four: Other Title Information

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

Section Six: Administrative Information

Projected publication date:   Month:     Year:    *
 
Email address to which PCN data should be sent:    *
 
Person completing this application:
 
Name:     *
Phone:    ( )  * Fax:    ( )   
Email:     *
 
Person who will send a copy of this book to the CIP Division immediately upon publication:
 
Name:     *
Phone:    ( )  * Fax:    ( )
Email:     *

Section Seven: Comments

Comments: