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* 1.
First Name/Last Name (*Optional)

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* 2. Institution Name

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* 3. Email address (Please provide your email address if you wish to be eligible for the drawing so we can contact you.)

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* 4. Please indicate the type of institution at which you teach.

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* 5. What is your job title?

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* 6. Are you currently using a Jones & Bartlett Learning text book or digital product?

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