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This form must be attached to your purchase order.
All requested information must be provided for us to process your order.

PO must be made out to: WiLS, 728 State Street, Room 464, Madison WI 53706.

Contact Person:______________________________________________
 
Library:_____________________________________________________

Street:_____________________________________________________

City, State, Zip:______________________________________________

Phone:________________________Fax:_________________________

Email: __________________________IP Range: _________________________

Circle prices of databases ordered.

FTE RefWorks RefShare add-on Module
1-3,000  $2,850 $  475
3,001-6,000  $3,990 $  950
6,001-10,000  $5,985  $1,425
10,001-13,000  $9,975  $1,900
13,001+  $12,350  $2,375