Directions for the Electronic Samples Submission Form
ED - 2168

Information will be released to Publishers participating in Section VI no later than November 7, 2011

Below are the instructions for completing Form ED-2168, Number of Sets of Official Samples. This information will be organized and forwarded to the various publishers once approved by the State Textbook Commission. It is imperative that you complete this form correctly if you would like to have samples of the items on the State Textbook List sent to your system.

If you have questions regarding the sampling process, please email Morgan Branch at morgan.branch@state.tn.us or phone him at 615-253-3160. If you have questions regarding the sample request form, please e-mail the Kellie Dumas kellie.dumas@tennesseebook.com.

1. Please “click” on the Sample Request Link listed below to request sample material.
2. DO NOT use the ENTER key while in the form. The ENTER key will activate the button at the bottom of the form. Use your mouse or the TAB key to maneuver around the fields in the form.
3. Please fill in the Requestors Information at the top of the form. This will create a central contact point to which information regarding the adoption process can flow.
4. Please fill in the Ship To information. P.O. Boxes are not a valid address for sample shipments.
5 . Please select the various categories of material you want sent into that specific location.
6 . Once the form has been completed, “click” the ADVANCE TO CONFIRMATION PAGE button at the bottom of the page. A confirmation page will appear for you to review prior to actually submitting the information to our database.
7 . If the information is not accurate, "click" the BACK button on your browser to recall the previous page and make any necessary changes. Then proceed again beginning with step 6.
8 . Once the information has been confirmed press the PRINT button on your browser to print a hardcopy of this request for your records.
9 . When printing has completed, “click” the SUBMIT button at the bottom of this form to send your information to Tennessee Book Company and The State Department of Education.