26-27 Compass Membership Request

26-27 Compass Membership Request

This form is intended to be completed only by authorized district administrators.
Requester Email*
Your email; example@example.com
Internal Email
Your email; example@example.com
Select your Accredited School*
If District is not listed, select OTHER. Double check all pre-filled data is accurate.
School District*
School Address*
Street Address
City*
City
State*
State / Province
Postal Code*
Postal / Zip Code
District Admin Contact
Admin First Name*
Admin Last Name*
Admin Email*
To receive request confirmation and Membership Info.
Billing Contact

This individual will receive the payment form to complete for district member request processing. Ensure this contact is the correct billing contact for completing the payment form.
First Name*
Last Name*
Email Address*
To receive and complete payment form.
Phone Number*
Number of Students*
Membership Tier*

Tier 1 ($1,000; 1-250 K-12 Students)Tier 2 ($2,000; 251-1,500 K-12 Students)Tier 3 ($4,000; 1,501+ K-12 Students)
Is your District/School interested in joining the CPL Shared OverDrive Collection?*

YesNo
Compass Membership Request Date*

MonthDayYear
Today's Date
Total (Auto Calculated)
Compass Membership Request Form Acknowledgement

By submitting this form, I acknowledge that the membership payment form will automatically be sent to the billing contact at the email address provided. The billing manager is responsible for completing the payment form and selecting either “Pay by Credit Card” or “Pay by Invoice” in a timely manner. If the payment form is not completed within a reasonable time frame, the membership request may expire and need to be re-completed.
Internal Use Only
Adjusted Rate Reasoning
Other
Adjusted Invoice Amount (Different from qtrly discount)
Total to be billed
Should be Empty:

26-27 Compass Membership Request

District Admin Contact

Billing Contact

Internal Use Only