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Online Resources Order Form

Use this form for ordering locally-licensed (Tier 3) online (including print+online) resources*
Use this form to initiate a Tier 2 purchase or subscription**

*Please do not use this form for initiating a UCI Trial
**Please do not use this form for participating in a Tier 2 purchase or subscription initiated at another UC campus

INSTRUCTIONS:

  • Sections I & II: Bibliographers fill out as appropriate and click on "Send Information".
    Send additional license or printouts to Head of Collection Department.
  • Section III: Head of Collection Department approval
I. ACQUISITIONS INFORMATION
***** All fields in red are required *****
Paid by: UCI (Tier 3)     UCI & others (Tier 2) (see section q.)
(see http://www.cdlib.org/inside/collect/tiers.html for Tier definitions)
Is this a RUSH order? No     Yes (please explain below:)
Bibliographer:      Date: 08/20/2017
Fundcode:  (Atleast one fund code is required)
(Tier 2 Fund Code:
To be completed by AUL for Research Resources or Head of Collections)
Title:
Is title part of a package or series? No      Yes
Please enter package or series information:
eISSN (if available; provide alternate ISSN if necessary):
Publisher:
Platform, if known:
Web Address:
Price Quote (please enter a numeric value only without any commas):  $(check all that apply):
In USD
Other currency:
for full access
server maintenance fee (describe in comments box below)

bundled package ((e.g. comes with membership, multi-title package); describe in comments box below)

Date price quote received (Please enter a valid date (mm/dd/yyyy):
Price quote provided by (i.e., vendor or publisher):
Vendor/publisher contact information:
Link to License Agreement, if available:
Type of fee:
One-time price
Annual subscription
Other (describe in comments box below)
Fee based on (check all that apply):
UCI FTE students/users (www.oir.uci.edu)
Department FTE (Department:)
Simultaneous users (provide number here:)
Library budget
Promotional Literature
Website
Tier 2 (check ALL campuses participating)
  UCB     UCD     UCI        UCLA     UCM   
  UCR     UCSB   UCSC    UCSD     UCSF   
free online w/ existing active print subscription
free online w/ print subscription, need to start new print subscription
free online w/ print subscription, need to reinstate print subscription
-- ANTPAC Bib Number (if reinstating previously canceled print subscription)
separate fees for print & online (describe in comments box below)


Other (describe in comments box below)
Formats (check only one that applies):
Online
    check here if canceling current print
      -- ANTPAC Bib Number (if existing print subscription)
Print & Online
Adding Online to Print
      -- ANTPAC Bib Number (if existing print subscription)
Other (describe in comments box below)
Where should it be listed on the Website?  (please check all that apply):
New Resources  
New Databases  
Online journals by publishers or collections
E-Books & E-Texts  
Other  (describe in comments box below)
Add a brief note describing the resource (for internal verification of resource during ordering process):
Additional comments (e.g. registration login and password, concurrent user limit, specially negotiated terms, etc.)

II. COLLECTION DEVELOPMENT INFORMATION
Requesting faculty (optional):
Preliminary checks for existing web access and other online ordering information:
Format (check all that apply):
Electronic journal(s)   
e-Book (single title order)   
e-Book package (check here if title-level cataloging desired:
Abstracts/index database   
Database of full-text (check here if titlelevel cataloging desired:
Web site   
Government document   
Numeric Data   
Directory or other reference tool  
Program/Interactive media
Software
Streaming Film/Video
Other (describe in comments box below):

Requires additional support (check all that apply):
Software to be loaded by IT   
Streaming video to be loaded by IT   
PDF files to be loaded by IT   
Other (describe in comments box):   

Enter your e-mail address if you want to receive a copy of this form: