EIG Connect Purchase & Onboarding Form

Please complete this form to set up your institution's subscription and services.

EIG Connect pricing is available exclusively to public libraries and institutions serving populations of 7,000 or fewer.

If you have any questions, please contact us at eigconnect@learnersengaged.com.

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Email *
Institution Information
Institution / Library Name *
Population Served *
Address *
City *
State / Province *
Zip / Postal Code *
Country *
Tax Exempt - GST / VAT Status
Clear selection
Tax ID (e.g. ABN/EIN/GST/VAT)
If applicable, please email your Tax Exempt Certificate to orders@learnersengaged.com

U.S. Libraries are not required to provide tax-exempt certificates. Learners Engaged will provide a W-8BEN as an international (Canada) vendor for your accounting records.
Primary Contact Name *
Primary Contact Title or Role *
Primary Contact Email *
Primary Contact Phone *
Primary Marketing / Outreach Contact Details
Marketing / Outreach Contact Name
Marketing / Outreach Title or Role
Marketing / Outreach Email
Marketing / Outreach Phone
Accounts / Finance Contact
Accounts / Finance Name *
Accounts / Finance Title or Role *
Accounts / Finance Email *
Accounts / Finance Phone *
Preferred Payment Method *
EIG Connect Subscription Selection (USD) *
Product Selection *
Select the solutions included in this subscription. Newsreel counts as one solution and adds a $100 per year premium on top of the package price.
Required
I understand that selecting Newsreel adds $100 per year on top of the EIG Connect package price, for each year of the subscription term. *
Subscription Start Date *
Month, day, year.
MM
/
DD
/
YYYY
Subscription Term *
Auto-Renewal *
ZIP Code / Postal Code (Patron Authentication)
I have read and agree to the EIG Connect Program Terms & Conditions. 
 *
Required
I am authorized to submit this order on behalf of my organization and agree to the EIG Connect Program Terms and Conditions. *
Required
Signature (Please type your full name as eSignature) *
Title of Authorized Signatory *
Date of Signature *
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
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