Return Authorization Request Form

Please place a copy of the Return Authorization Form in the carton returned. Items not returned directly to Tinley Park or returned without a Return Authorization Form may be subject to a restocking fee and/or additional shipping charges.

*Name

Phone Number

Fax Number

School/Co.

*E-mail Address

*Address 1

Address 2

*City

*State/Province
Alabama Alaska Alberta American Samoa Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland and Labrador North Carolina North Dakota Northwest Territories Nova Scotia Nunavut Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon
*Zip/Postal Code

Claim # (if applicable)

 

Title

ISBN

*Qty to Return

*PO # / Invoice #

Second Title

Second ISBN

Second Qty to Return

Second PO # / Invoice #

Third Title

Third ISBN

Third Qty to Return

Third PO # / Invoice #

Fourth Title

Fourth ISBN

Fourth Qty to Return

Fourth PO # / Invoice #

Fifth Title

Fifth ISBN

Fifth Qty to Return

Fifth PO # / Invoice #