D

®

A G R E E M E N T F O R MDetailed instructions, Author Discount Order Form and Subject Categories List

Doctoral DissertaTion

ITEM 1: Full name. This should be identical to thename on your title page, since your name will be usedto access your dissertation in the database.

ITEM 3: Future mailing address. This is the addressat which you can be reached after you have completed your degree requirements. It will be used in mailingany royalties due from the sale of your dissertation.

ITEM 4: Please enter university name, plus collegeor department within the university. For example:Harvard University, School of Divinity.

ITEM 8: Dissertation title. The words used in thetitle of your dissertation are the access points forresearchers who may use computerized keywordsearching techniques to identify works in varioussubject areas. The words in your title should beselected carefully to represent as accurately as possible the subject content of your dissertation.

The published title will be upper/ lower case. Toensure accuracy, the author should include allappropriate accents or diacritical marks.

Authors of scientific and engineering dissertationsshould use word substitutes for formulas, symbols,and superscripts or subscripts, Greek letters, etc. Forexample, “Metabolic relationships of Pi and K+uptake mechanisms in snap bean (P. vulgaris) roots”should be written “Metabolic relationships of inorganic phosphate and potassium uptake mechanisms in snap bean (Phaseolus vulgaris)roots.”

ITEM 9: Additional keywords. If retrieval of yourdissertation would be enhanced, you may add up tofive keywords. For example, geographical locationsor scientific names not mentioned in your title orabstract might be listed.

ITEM 10: Dissertation subject category. Select fromthe “Subject Categories” list on page A3 the categoryrelated to the discipline and content of your dissertation, under which you wish to have yourabstract published. Enter the corresponding four-digit code and the category name. If you wish, youmay indicate additional subject codes and categoriesthat would enhance electronic retrieval.

ITEM 12: UMI Dissertation Publishing will file, onyour behalf, an application for registration of aclaim of copyright for your dissertation. Pleasecomplete the “Authorization to Apply forRegistration of My Claim to Copyright” section onpage A5. The certificate of registration will be mailedto you by the Copyright Office approximately six toeight weeks after we receive your dissertation forpublication. This service is available only forauthors publishing their dissertations with UMIDissertation Publishing.

If your dissertation has been previously publishedand is registered with the Copyright Office, pleaseenter the copyright notice on the back of the form,exactly as it appears in the previously publishededition.

If you have any questions as you complete this form,please feel free to call toll free at 800-521-0600, ext.7020, or email disspub@umi.com.

Instructions For Doctoral Dissertation Agreement Form. Please complete this agreement carefully, so that your dissertation can be published as rapidly as possible. Please type or print, and look through the followinginstructions for explanations concerning the Agreement Form.

m Does your dissertation abstract adhere to the maximum word lengthof 350 words? (We reserve the right to edit longer abstracts.)

m Are permission letters for previously copyrighted materials attachedto the Agreement Form?

m Do the copyright permission letters state that ProQuest Informationand Learning may supply copies on demand?

m Have you attached a copy of your abstract and title page to the Agreement Form?

m Is your adviser’s name and title clearly indicated?

m Is your name, in full, on the title page of the work, the abstract, andthe Agreement Form? Is the name identical on all three? The manuscriptwill be published under the most complete name given, if unclear.

m Have you signed in the appropriate places on the back of the Agreement Form?

m Have you included your Social Security number?

m Are words substituted for formulas and symbols in the title? Are accents included?

m Is a subject classification indicated on the Agreement Form?

m Our most common problem is missing pages. Are all pages presentand numbered consecutively?

m If the work is to be copyrighted, is all the appropriate information completed on the Agreement Form?

m Have you enclosed a check or money order for your copyright fee? (Credit cards not accepted for copyright fee.)

m Have you enclosed payment for your author discount copies? Seepage A6. (Credit card, check, or money order is acceptable.)

m Have you included an English title and abstract if original is in another language?

Author Check List If you have any questions concerning the publication of your manuscript,call toll free at 800-521-0600. Ask for UMI Dissertation Publishing Customer Service at ext. 7020, or email disspub@umi.com.

A2

The Humanities and Social Sciences

The Sciences and Engineering

Subject Categories The dissertation database is arranged by subject categories. Pleaseselect the one subject which most nearly describes the content of your dissertation. If you need assistance choosinga subject code or keywords, call us toll free at 800-521-0600 and ask for ext. 4883 for social sciences and humanities,or ext. 4881 for sciences and engineering.

COMMUNICATIONS AND THE ARTSArchitecture . . . . . . . . . . . . . . . .0729Art History . . . . . . . . . . . . . . . . .0377Cinema . . . . . . . . . . . . . . . . . . . .0900Dance . . . . . . . . . . . . . . . . . . . . .0378Design and Decorative Arts . . .0389Fine Arts . . . . . . . . . . . . . . . . . . .0357Information Science . . . . . . . . .0723Journalism . . . . . . . . . . . . . . . . .0391Landscape Architecture . . . . . .0390Library Science . . . . . . . . . . . . .0399Mass Communications . . . . . . .0708Music . . . . . . . . . . . . . . . . . . . . .0413Speech Communication . . . . . .0459Theater . . . . . . . . . . . . . . . . . . . .0465

EDUCATIONGeneral . . . . . . . . . . . . . . . . . .0515Administration . . . . . . . . . . . .0514Adult and Continuing . . . . . .0516Agricultural . . . . . . . . . . . . . . .0517Art . . . . . . . . . . . . . . . . . . . . . .0273Bilingual and Multicultural . .0282Business . . . . . . . . . . . . . . . . .0688Community College . . . . . . . .0275Curriculum and Instruction . .0727Early Childhood . . . . . . . . . . .0518Educational Psychology . . . .0525Elementary . . . . . . . . . . . . . . .0524Finance . . . . . . . . . . . . . . . . . .0277Guidance and Counseling . . .0519Health . . . . . . . . . . . . . . . . . . .0680Higher . . . . . . . . . . . . . . . . . . .0745History of . . . . . . . . . . . . . . . .0520Home Economics . . . . . . . . . .0278Industrial . . . . . . . . . . . . . . . . .0521Language and Literature . . . .0279Mathematics . . . . . . . . . . . . . .0280Music . . . . . . . . . . . . . . . . . . . .0522

Philosophy of . . . . . . . . . . . . .0998Physical . . . . . . . . . . . . . . . . . .0523Reading . . . . . . . . . . . . . . . . . .0535Religious . . . . . . . . . . . . . . . . .0527Sciences . . . . . . . . . . . . . . . . .0714Secondary . . . . . . . . . . . . . . . .0533Social Sciences . . . . . . . . . . .0534Sociology of . . . . . . . . . . . . . .0340Special . . . . . . . . . . . . . . . . . .0529Teacher Training . . . . . . . . . . .0530Technology . . . . . . . . . . . . . . .0710Tests and Measurements . . .0288Vocational . . . . . . . . . . . . . . . .0747

LANGUAGE, LITERATURE, AND LINGUISTICSLanguage

General . . . . . . . . . . . . . . . . . .0679Ancient . . . . . . . . . . . . . . . . . .0289Linguistics . . . . . . . . . . . . . . . .0290Modern . . . . . . . . . . . . . . . . . .0291Rhetoric and Composition . .0681

LiteratureGeneral . . . . . . . . . . . . . . . . . .0401Classical . . . . . . . . . . . . . . . . .0294Comparative . . . . . . . . . . . . . .0295Medieval . . . . . . . . . . . . . . . . .0297Modern . . . . . . . . . . . . . . . . . .0298African . . . . . . . . . . . . . . . . . . .0316American . . . . . . . . . . . . . . . .0591Asian . . . . . . . . . . . . . . . . . . . .0305Canadian (English) . . . . . . . . .0352Canadian (French) . . . . . . . . .0355Caribbean . . . . . . . . . . . . . . . .0360English . . . . . . . . . . . . . . . . . .0593Germanic . . . . . . . . . . . . . . . .0311Latin American . . . . . . . . . . . .0312Middle Eastern . . . . . . . . . . . .0315

Romance . . . . . . . . . . . . . . . . .0313Slavic and East European . . .0314

PHILOSOPHY, RELIGION, AND THEOLOGYPhilosophy . . . . . . . . . . . . . . . . .0422Religion

General . . . . . . . . . . . . . . . . . .0318Biblical Studies . . . . . . . . . . .0321Clergy . . . . . . . . . . . . . . . . . . .0319History of . . . . . . . . . . . . . . . .0320Philosophy of . . . . . . . . . . . . .0322

Theology . . . . . . . . . . . . . . . . . .0469

SOCIAL SCIENCESAmerican Studies . . . . . . . . . . .0323Anthropology

Archaeology . . . . . . . . . . . . . .0324Cultural . . . . . . . . . . . . . . . . . .0326Physical . . . . . . . . . . . . . . . . . .0327

Business AdministrationGeneral . . . . . . . . . . . . . . . . . .0310Accounting . . . . . . . . . . . . . . .0272Banking . . . . . . . . . . . . . . . . . .0770Management . . . . . . . . . . . . .0454Marketing . . . . . . . . . . . . . . . .0338

Canadian Studies . . . . . . . . . . .0385Economics

General . . . . . . . . . . . . . . . . . .0501Agricultural . . . . . . . . . . . . . . .0503Commerce-Business . . . . . . .0505Finance . . . . . . . . . . . . . . . . . .0508History . . . . . . . . . . . . . . . . . . .0509Labor . . . . . . . . . . . . . . . . . . . .0510Theory . . . . . . . . . . . . . . . . . . .0511

Folklore . . . . . . . . . . . . . . . . . . . .0358Geography . . . . . . . . . . . . . . . . .0366Gerontology . . . . . . . . . . . . . . . .0351

HistoryGeneral . . . . . . . . . . . . . . . . . .0578Ancient . . . . . . . . . . . . . . . . . .0579Medieval . . . . . . . . . . . . . . . . .0581Modern . . . . . . . . . . . . . . . . . .0582Black . . . . . . . . . . . . . . . . . . . .0328Church . . . . . . . . . . . . . . . . . . .0330African . . . . . . . . . . . . . . . . . . .0331Asia, Australia, and Oceania .0332Canadian . . . . . . . . . . . . . . . . .0334European . . . . . . . . . . . . . . . .0335Latin American . . . . . . . . . . . .0336Middle Eastern . . . . . . . . . . . .0333United States . . . . . . . . . . . . .0337

History of Science . . . . . . . . . . .0585Law . . . . . . . . . . . . . . . . . . . . . . .0398Political Science

General . . . . . . . . . . . . . . . . . .0615International Law and

Relations . . . . . . . . . . . . . . .0616Public Administration . . . . . .0617

Recreation . . . . . . . . . . . . . . . . .0814Social Work . . . . . . . . . . . . . . . .0452Sociology

General . . . . . . . . . . . . . . . . . .0626Criminology and Penology . .0627Demography . . . . . . . . . . . . . .0938Ethnic and Racial Studies . . .0631Individual and Family

Studies . . . . . . . . . . . . . . . . .0628Industrial and Labor

Relations . . . . . . . . . . . . . . .0629Public and Social Welfare . . .0630Social Structure and

Development . . . . . . . . . . . 0700Theory and Methods . . . . . . .0344

Transportation . . . . . . . . . . . . . .0709Urban and Regional Planning .0999Women’s Studies . . . . . . . . . . . .0453

BIOLOGICAL SCIENCESAgriculture

General . . . . . . . . . . . . . . . . . .0473Agronomy . . . . . . . . . . . . . . . .0285Animal Culture and

Nutrition . . . . . . . . . . . . . . .0475Animal Pathology . . . . . . . . .0476Fisheries and Aquaculture . .0792Food Science and

Technology . . . . . . . . . . . . .0359Forestry and Wildlife . . . . . . .0478Plant Culture . . . . . . . . . . . . . .0479Plant Pathology . . . . . . . . . . .0480Soil Science . . . . . . . . . . . . . .0481Range Management . . . . . . .0777Soil Science . . . . . . . . . . . . . .0481Wood Technology . . . . . . . . .0746

BiologyGeneral . . . . . . . . . . . . . . . . . .0306Anatomy . . . . . . . . . . . . . . . . .0287Animal Physiology . . . . . . . . .0433Biostatistics . . . . . . . . . . . . . .0308Botany . . . . . . . . . . . . . . . . . . .0309Cell . . . . . . . . . . . . . . . . . . . . .0379Ecology . . . . . . . . . . . . . . . . . .0329Entomology . . . . . . . . . . . . . . 0353Genetics . . . . . . . . . . . . . . . . .0369Limnology . . . . . . . . . . . . . . . .0793Microbiology . . . . . . . . . . . . .0410Molecular . . . . . . . . . . . . . . . .0307Neuroscience . . . . . . . . . . . . .0317Oceanography . . . . . . . . . . . .0416Plant Physiology . . . . . . . . . .0817Veterinary Science . . . . . . . . .0778Zoology . . . . . . . . . . . . . . . . . .0472

BiophysicsGeneral . . . . . . . . . . . . . . . . . .0786Medical . . . . . . . . . . . . . . . . . .0760

EARTH AND ENVIRONMENTAL SCIENCESBiogeochemistry . . . . . . . . . . . .0425Environmental Sciences . . . . . .0768Geochemistry . . . . . . . . . . . . . . .0996Geodesy . . . . . . . . . . . . . . . . . . .0370Geology . . . . . . . . . . . . . . . . . . .0372Geophysics . . . . . . . . . . . . . . . . .0373Hydrology . . . . . . . . . . . . . . . . . .0388Mineralogy . . . . . . . . . . . . . . . . .0411Paleobotany . . . . . . . . . . . . . . . .0345Paleoecology . . . . . . . . . . . . . . .0426Paleontology . . . . . . . . . . . . . . .0418Paleozoology . . . . . . . . . . . . . . .0985Palynology . . . . . . . . . . . . . . . . .0427Physical Geography . . . . . . . . .0368Physical Oceanography . . . . . .0415

HEALTH SCIENCESHealth Sciences

General . . . . . . . . . . . . . . . . . .0566Audiology . . . . . . . . . . . . . . . .0300Dentistry . . . . . . . . . . . . . . . . .0567Education . . . . . . . . . . . . . . . .0350Health Care Management . . .0769Human Development . . . . . .0758Immunology . . . . . . . . . . . . . .0982Medicine and Surgery . . . . . .0564Mental Health . . . . . . . . . . . . .0347Nursing . . . . . . . . . . . . . . . . . .0569Nutrition . . . . . . . . . . . . . . . . .0570Obstetrics and Gynecology . .0380Occupational Health and

Safety . . . . . . . . . . . . . . . . . .0354Oncology . . . . . . . . . . . . . . . .0992Ophthalmology . . . . . . . . . . .0381Pathology . . . . . . . . . . . . . . . .0571Pharmacology . . . . . . . . . . . .0419Pharmacy . . . . . . . . . . . . . . . .0572Public Health . . . . . . . . . . . . .0573Radiology . . . . . . . . . . . . . . . .0574

Recreation . . . . . . . . . . . . . . . .0575Rehabilitation and Therapy . .0382Speech Pathology . . . . . . . . .0460Toxicology . . . . . . . . . . . . . . .0383

Home Economics . . . . . . . . . . .0386

PHYSICAL SCIENCESPure SciencesChemistry

General . . . . . . . . . . . . . . . . . .0485Agricultural . . . . . . . . . . . . . . .0749Analytical . . . . . . . . . . . . . . . .0486Biochemistry . . . . . . . . . . . . .0487Inorganic . . . . . . . . . . . . . . . . .0488Nuclear . . . . . . . . . . . . . . . . . .0738Organic . . . . . . . . . . . . . . . . . .0490Pharmaceutical . . . . . . . . . . . .0491Physical . . . . . . . . . . . . . . . . . .0494Polymer . . . . . . . . . . . . . . . . . .0495Radiation . . . . . . . . . . . . . . . . .0754

Mathematics . . . . . . . . . . . . . . .0405Physics

General . . . . . . . . . . . . . . . . . .0605Acoustics . . . . . . . . . . . . . . . .0986Astronomy and

Astrophysics . . . . . . . . . . . .0606Atmospheric Science . . . . . . .0608Atomic . . . . . . . . . . . . . . . . . . .0748Condensed Matter . . . . . . . . .0611Electricity and Magnetism . .0607Elementary Particles and

High Energy . . . . . . . . . . . .0798Fluid and Plasma . . . . . . . . . .0759Molecular . . . . . . . . . . . . . . . .0609Nuclear . . . . . . . . . . . . . . . . . .0610Optics . . . . . . . . . . . . . . . . . . .0752Radiation . . . . . . . . . . . . . . . . .0756

Statistics . . . . . . . . . . . . . . . . . . .0463Applied SciencesApplied Mechanics . . . . . . . . . .0346Computer Science . . . . . . . . . . .0984

EngineeringGeneral . . . . . . . . . . . . . . . . . .0537Aerospace . . . . . . . . . . . . . . . .0538Agricultural . . . . . . . . . . . . . . .0539Automotive . . . . . . . . . . . . . . .0540Biomedical . . . . . . . . . . . . . . .0541Chemical . . . . . . . . . . . . . . . . .0542Civil . . . . . . . . . . . . . . . . . . . . .0543Electronics and Electrical . . .0544Environmental . . . . . . . . . . . .0775Industrial . . . . . . . . . . . . . . . . .0546Marine and Ocean . . . . . . . . .0547Materials Science . . . . . . . . . .0794Mechanical . . . . . . . . . . . . . . .0548Metallurgy . . . . . . . . . . . . . . .0743Mining . . . . . . . . . . . . . . . . . . .0551Nuclear . . . . . . . . . . . . . . . . . .0552Packaging . . . . . . . . . . . . . . . .0549Petroleum . . . . . . . . . . . . . . . .0765Sanitary and Municipal . . . . .0554System Science . . . . . . . . . . .0790

Geotechnology . . . . . . . . . . . . .0428Operations Research . . . . . . . . .0796Plastics Technology . . . . . . . . . .0795Textile Technology . . . . . . . . . . .0994

PSYCHOLOGYGeneral . . . . . . . . . . . . . . . . . .0621Behavioral . . . . . . . . . . . . . . . .0384Clinical . . . . . . . . . . . . . . . . . .0622Cognitive . . . . . . . . . . . . . . . . .0633Developmental . . . . . . . . . . . .0620Experimental . . . . . . . . . . . . .0623Industrial . . . . . . . . . . . . . . . . .0624Personality . . . . . . . . . . . . . . .0625Physiological . . . . . . . . . . . . .0989Psychobiology . . . . . . . . . . . .0349Psychometrics . . . . . . . . . . . .0632Social . . . . . . . . . . . . . . . . . . .0451

A3

Do not write in this space.

Royalty _______________ Yes*

Restriction Code ____________

Total Pages ________________

Vol./Issue __________________

School Code _______________

Copyright m Yes m No

Year ______________________

Personal Data Please type or print in block letters.

1.Last Name First Name Middle Name

2. Country of citizenship __________________________________________________________________

3. Present Mailing Address

Street Address

City State Zip or Postal Code

Country

Future Mailing Address

Street Address

City State Zip or Postal Code

Country

Effective date for future mailing address (mm dd yy) ____________________________________________

Home telephone number ( ) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Business phone ( ) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Email ______________________________________________________________________________

Doctoral Degree Data4. Full name of university conferring degree, and college or division if appropriate

______________________________________________________________________________________________________________________________________________________________________Department of university ________________________________________________________________Adviser _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

5. Abbreviation for degree awarded __________________________________________________________6. Year degree awarded _____________________ 7. Year manuscript completed _____________________

Dissertation Title and Subject Data8. Important: Attach a copy of your dissertation title page and abstract to this Agreement Form. Please

make sure the name of your adviser/director appears on either the title page or the abstract.

9. List up to six keywords or short phrases for indexing and database access:

a. ___________________________________ d. ______________________________________

b. ___________________________________ e. ______________________________________

c. ___________________________________

10. Subject category for your manuscript. Enter four-digit code from ”Subject Categories“ list on Page A3, followedby the name of the category selected.

______________________ ________________________________________________________(You may enter two additional categories and/or codes on the extra lines provided.)

______________________ ______________________________________________________________________________ ________________________________________________________

11. Primary language of text (if other than English) ________________________________________________

Copyright Data12. If you would like to have filed, on your behalf, an application for registration of a claim of U.S. copyright for

your dissertation, please read and sign the ”Authorization“ section on the reverse side of this Agreement Form. (over)

IMPORTANT: You must sign the “Dissertation Publishing Agreement Form” on thereverse side of this page.

Doctoral Dissertation agreement Form FORM D (2003) For assistance, call toll free in the US and Canada: 800-521-0600, ext. 7020.

A4

f. _______________________________________

Dissertation Publishing Agreement Through my graduate school, Iagree to supply you, ProQuest Information and Learning Company (PQIL),with my paper dissertation and with an abstract of 350 words or less. The titleof my dissertation is set forth on the accompanying title page. If my disserta-tion is being submitted in a digital format, including CD-ROM, I agree to sup-ply you, ProQuest Information and Learning Company (PQIL), with my dis-sertation in digital format and the following supporting documents on paper:a title page, an abstract of 350 words or less, a description of software or otherapplications used to create the document, including a list of files and filesizes, copies of licenses for third party software which will be replicated, dis-tributed and used with the document and written permission to distribute anythird party software, as well as previously copyrighted materials within thebody of the work including images, video, graphics, text, data and images ofindividuals.

I hereby grant to PQIL the non-exclusive right to reproduce and distributemy dissertation, in whole or in part, in and from microform along with thenon-exclusive right to reproduce and distribute my abstract in any format inwhole or in part. Further, I hereby grant to PQIL the non-exclusive right toreproduce and distribute my dissertation, in whole or in part, in and from anelectronic format. Other publication rights may be granted as I choose.

I represent and warrant to PQIL that the dissertation and the abstract are myoriginal work, do not infringe or violate any rights of others, and that I makethese grants as the sole owner of the rights to my dissertation and abstract. Ifmy dissertation is in CD-ROM or another digital format, I further represent andwarrant that I have obtained all necessary rights to permit PQIL to reproduceand distribute any non-public third party software necessary to access, display,run or print my dissertation. I acknowledge that PQIL may elect not to distribute my dissertation in digital format if, in its reasonable judgment, itbelieves all such rights have not been secured.

Subject to the preceding paragraphs, PQIL agrees to offer copies of my dissertation for sale, and to publish an abstract of my dissertation inDissertation Abstracts International. In accordance with the Copyright Act of1976, PQIL will deposit one copy of my dissertation with the Library ofCongress. This deposit will be in digital, microform or other format asrequired by the Library of Congress and will be available for inspection. PQILalso agrees to pay a royalty of 10% on all sales of my dissertation. Royaltypayments must exceed $10 in a calendar year to be paid. In order to be eligible for such royalties in any calendar year, I agree that it is my obligation to notify PQIL of any change of address.

Publishing Agreement Form

Author’s Signature ______________________________________________________ Date _____________________________Publishing Authorization

Social Security Number - -

Required for payment of royalties

Authorization to Apply for Registration of My Claim to Copyright

Has registration for your published dissertation, or for an earlier version of the manuscript, been made with the Copyright Office? Yes No

If “Yes,” by whom was the registration made? _________________________________________________________________________

Previous registration number _______________________________ Year of Registration _______________

I authorize you, PQIL, to file in my behalf, an application for registration of a claim of U.S. copyright, in my name, for my dissertation. PQIL agrees to com-

plete the application form, and file it, together with the registration fee and required deposit copy(ies) of my dissertation, with the Copyright Office. I represent

to PQIL that the information I have provided PQIL on the accompanying information questionnaire is accurate.

My certified check or money order to PQIL for $65.00 is enclosed, unless I have paid the fee to my graduate school for forwarding to PQIL. I understand that I

will receive the registration form from the Copyright Office.

Author’s Signature ___________________________________________________________ Date _________________________Copyright Authorization

A5

D o c t o r a l D i s s e r t a t i o n a g r e e m e n t f o r m

ProQuest Information and Learning 789 Eisenhower Parkway, P.O. Box 1346, Ann Arbor, Michigan 48106-1346 USA • 800.521.0600 • www.umi.com

Author Discount ORDER FORM latoTecirPtamroFytQ

Price

4 Hardcover copies (8 1/2" x 11") $125.00

4 Hardcover copies (6 1/2" x 8 1/4") $115.00

3 Hardcover copies (8 1/2" x 11") $105.00

3 Hardcover copies (6 1/2" x 8 1/4") $95.00

Softcover copies (6 1/2" x 8 1/4") $29.00

Hardcover copies (6 1/2" x 8 1/4") $35.00

Hardcover copies (8 1/2" x 11") $40.00

Microfiche copy (105mm) 98-page format $16.00

Sub-Total

Sales Tax

Total

Enclosed is my cashier’s check, money order, or certified checkmade payable to ProQuest Information and Learning Company in theamount of $ ____________.

Please charge my:

American Express Visa MasterCard

Account No. _______________________________________________________________

Expiration Date _______________________________________________________________

Signature __________________________________________________________________

(Authors, please note: Your account will not be charged until yourcopies have been shipped.)

Send the above order to: ___________________________________

Name

Address

City/State/Zip

Phone (business hours)

Fill in the Author Discount Order Form for copies of your dissertation. Attach it to your signed and completed Agreement Form and return it to ProQuest Information and Learning, 789 Eisenhower, P.O. Box 1346, Ann Arbor, Michigan 48106-1346.

Dissertation copies are shipped approximately 4 to 6 weeks after we receiveyour manuscript for publication.

Authors, Please Note:

• Author orders do not earn a royalty.

• Please inform us of any address change.

• All prices are subject to change.

Instructions for ordering dissertation copies:

• All orders must be accompanied by payment in full by credit card, cashier’scheck, money order, or certified check.

• Enter the quantity and total price for each format ordered.

author Discount OfferFORM D For assistance, call toll free in the US and Canada: 800-521-0600, ext. 7020.

Do not write in this space.

Release date ____________ Packing slip number ______________

• Add sales tax for the state to which this order will be shipped.

• Please type or print.

If you have any questions, please call UMI DissertationPublishing toll free at 800-521-0600, ext. 7020.

Author’s name as it appears on dissertation:

Last name

eman elddiMeman tsriF

First three words of dissertation title

Graduate school

Year degree awarded

Order Now and Save up to 45% on Copies of Your Dissertation Producing copies of your dissertation is less expensive atthe time of publication than at any other time. We pass these savings along to you now in the form of a substantial discount. Take advantage of this opportunity toacquire copies of your dissertation: • for your personal use • for distribution • for future reference. For the greatest discount, choose from these packages:

ProQuest Information and Learning 789 Eisenhower Parkway, P.O. Box 1346, Ann Arbor, MI 48106-1346 USA • 800.521.0600 • www.umi.com

"4/1 8 x "2/1 6"11 x "2/1 8• 4 copies = $125.00 Hardcover Packages • 4 copies = $115.00• 3 copies = $105.00 • 3 copies = $95.00

A6