Web Form for Access to Premium Resources

To access the Premium Resources, please complete and submit the following information. Your membership will be confirmed and an email with your username and password will be sent to you within 72 hours. Please contact Terri Bokosky in Library Development at 949.824.4651 or tbokosky@uci.edu should you have any questions.
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First Name*Last Name*
Street Address (Line 1)*
Street Address (Line 2)
City*State*   Zip Code*
E-mail Address*Phone number