Date __/__/__

Thesis Binding Form

Last Name: __ __ __ __ __ __ __ __ __ __ __ First: __ __ __ __ __ __ __ __ __ __ __ Initial: __.  

University ID Number __ __ __ - __ __ __ -__ __ __ __ Phone (__ __ __) __ __ __ -__ __ __ __  

Home Address: ____________________________ City/State/Zip _________________________  

Seton Hall Department/Program: ___________________________________________________ 

Thesis Adviser: ________________________________ Phone (__ __ __) __ __ __ - __ __ __ __ 

Thesis Type:  ___Masters ___ Ed.D. ___ Ph.D. ___Other  

Total number of copies to be bound:_____ 

Thesis Title (please print) __________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

All fees must be paid at the University Library Administration Office, 2nd Floor.  

$_ _ _. 00 Binding: $75.00 for 3 copies (University Archives, Department Archives, Author's copy); $25
                 for each additional copy (provided by the candidate) . Check payable to Seton Hall University.
$_ _ _. 00 Microfilming: $55.00. Required for Doctoral thesis. Check payable to UMI, Inc.
$_ _ _. 00 Copyright: $65.00 (optional) for registration with the Library of Congress Office of Copyright.
                 Check payable to UMI, Inc.
$_ _ _. 00  <<< Total 

Pick up at the University Library or Mail: __ Mail or __Pick up at University Library

Mailing Address 

Name: __________________________________________________________________

Address: ________________________________________________________________

City: ________________________________________ State: _____________________

Telephone Number (_ _ _) _ _ _ - _ _ _ _; E-Mail Address ________________________

(Revised on 11/9/2006)