This application should be submitted to the ISBN Agency at least two (2) months prior to the intended date of publication.

ISBN is requested for the following title:

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Title.........................................................................................................................................................................................

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Edition         New   Revised   Reprint         Binding         Hardcover   Paperback  

Date of Publication...................................... Number of Pages/Vols..................................................

Name of Series (if any)...............................................................................................................................

Number of Copies to be Printed............................................................................................................

Publisher's Name and Address...................................................................................................................

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Tel..............................................  FAX.................................................. E-mail...........................................

Signature of Publisher............................................................................................................................