Review Copy Request Form
To request a free copy to review for use in an academic setting, please complete the form below, or contact us at hesperian@hesperian.org. United States mailing address is required.
Salutation
Please include your preferred title (Dr., Professor, Ms., etc.)
Your answer
First Name
Your answer
Last Name
Your answer
Email
Use your university-affiliated email address
Your answer
Phone
E.g. (123) 456-7891 ext. 123
Your answer
University/Institution Name
Your answer
Mailing address
Please include street address, city, state, and zip code
Your answer
Link to teaching bio
Please copy and paste a link to your bio on a university website
Your answer
What book(s) are you interested in receiving? Please do not select more than 3 titles: Recruiting the Heart, Training the Brain; Health Actions for Women; Community Guide to Environmental Health; Workers' Guide to Health and Safety; Helping Health Workers Learn; A Book for Midwives; Where There Is No Doctor; Where There Is No Dentist; Childbirth Picture Book; A Health Handbook for Women with Disabilities; Helping Children Who Are Deaf; Helping Children Who Are Blind; Disabled Village Children.
Your answer
How do you hope to use Hesperian materials in your class(es)?
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Hesperian Health Guides. Report Abuse - Terms of Service - Additional Terms