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Customer Information
  Contact Name:
   Organization:
 
  Street Address:
   City, State & Zip:
 
  Daytime Phone:
   E-Mail:

Project Information
   Is the project a textbook or worksheet pages?
Textbook
Worksheets
 
   Project Title or Book Title
    Project Due Date
 
  Do you wish to receive partial shipments as sections of your project are complete?
  Yes, send sections as complete
  No, send entire project when complete
 
  Total Number Of Pages:

Including preliminary, body & appendix pages. Double-sided worksheets count as 2 pages.
 
   Please upload a section of the material or book; at least 20 pages from throughout the project including the book cover and copyright page if applicable.

For textbooks only, please fill out the following
  Book Title:
   Publisher:
 
  Copyright Year:
   ISBN (10 or 13 Digit Number):
 
  Will you provide the textbook to IPI for transcription?
  Yes, I have a hard copy available to send. I understand it will be destroyed in the transcription process and will not be returned.
  No, I need IPI to attempt to purchase the textbook. The cost will be included on the quote.

Transciption Information
  Braille Code:
   Grade Level:
 
  Contractions:
 Contracted
 Non-Contracted 		  Line Spacing:
 Single Spaced
 Double-Spaced
 
  Production Method:
 19-hole bound volumes
 Print page stapled to the braille 		  Tactile Graphics:
 Yes, include tactile graphics
 No, do not include tactile graphics
 
  Volume Types (if applicable):
 Interpoint
 Single-Sided 		   
 
  Consumable Formatting:
Consumable materials are transcribed so that the student can insert answers directly onto the embossed braille page. The material will be single-sided and any exercises that require answers will have added space for answers.
 Yes, leave space for answers
 No, do not leave space for answers
 
  Use the IPI Agency Specifications for the formatting and production of the braille materials:
 Yes
 No (specifications must be provided)
 
Additional Information
   Please use this field to include any additional information regarding your project.
  
   
 
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