UQL CYBERSCHOOL DATABASE SUBSCRIPTION / RENEWAL FORM

New Subscription or Renewal		New Subscription Renewal
Name of School	^*
Contact Person	^*
email	^*
Name of database	^*
School Order Number	^*
Price (include pro rata database pricing where applicable)	^*
Start Date	^*
End Date
Number of Licensed Concurrent Users (if applicable)
IP Range (if applicable)
Number of students enrolled (if applicable)
Licence agreement form faxed (if applicable)		Yes No
Special invoicing requirements
Any other notes
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