Please provide the following information to place an order with AdjunctSuccess. Click [Send Form] to forward the information to the AdjunctSuccess staff. For your records, a printable receipt will appear after you click [Send Form].

My Information * indicates a required field.
First Name:*
Last Name , Title:*
Email Address:*
Phone Number
Mailing Address 1:
Mailing Address 2:
City:
State/Province:
Zip/Postal Code:
Country:
Discipline:
Time Zone
Internet Speed
Best Webinar Time
Years Experience
   
My Institution's Information
Name:
City:
State:
Country:
Type
   

Please indicate the service(s) you wish to order for the period August 1, 2008 through June 15, 2009 [an academic year]:

AdjunctSuccess Support System for Part-time Faculty
Individual Adjunct Instructor $ 49.00
Institutional Licensing Fees:
10 to 100 adjunct instructors $ 39.50 each
From 101 to 200 instructors $ 33.50 each
From 201 to 400 instructors $ 25.50 each
From 401 to 600 instructors $ 19.50 each
From 601 to 800 instructors $ 12.50 each
Over 800 instructors $ 9.50 each
Instructors:
20% Discount Eligibility (please check if applicable)
NCSPOD, paid 2008-09 member
Starlink Professional Development Network, paid 2008-09 member
POD Network, paid 2008-09 member
Returning AdjunctSuccess paid 2007-08 member
Webinars for Instructional Leaders (not included in AdjunctSuccess Support System)
"Optimizing the Success of Your Adjunct Faculty" Open Version
@ $159.00
Date of Webinar:*

"Optimizing the Success of Your Adjunct Faculty" Closed Version
Up to 25 participants from a single institution $425

Terms/conditions: Upon receipt of order, an invoice will be provided via e-mail to the contact person identified above. Payment in U.S. dollars (or local currency at current exchange rate) is due within 30 days of the invoice date. For those who intend to register over 800 instructors, please e-mail Dr. Lyons, providing the number of instructors that you would like to register, as well as telephone number and most convenient contact times. Institutions purchasing any product are responsible to provide the names and e-mail addresses of users it is registering five days in advance of accessing the product. Access to any AdjunctSuccess product is limited to the individual registered, and may not be displayed, for other than demonstration purposes, to any non-registered individual or group.