Web Service License request form

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Web Service License request form	Become a Member \| Log In

Please complete the following form. A confirmation email will be sent to the technical contact together with your license key and instructions how to use our web service.

*Organization, Institution, or Campus:
*Primary Application:
Other Primary Application:
Number of Instructors:
Number of Students:
*Non-Profit:	Yes No
Authorized Agent Contact
*Title:
*First Name:
*Last Name:
*Address:
*City:
*State:
*Country:
*Phone:
*Email:
Technical Contact
*Title:
*First Name:
*Last Name:
*Address:
*City:
*State:
*Country:
*Phone:
*Email:
Agreement:	MERLOT Web Services and Related Software - License Key Release Terms The undersigned agrees to the terms and conditions defined in the: MERLOT Web Services and Related Software Agreement (at http://taste.merlot.org/wsrs.html) MERLOT Acceptable Use Agreement (at http://taste.merlot.org/acceptableuserpolicy.html) The undersigned agrees that 1) the terms of these agreements apply to all users of their Organization, Institution or Campus field shown on this webpage, and 2) the assigned key shall only be used on the Organization, Institution or Campus servers identified on this application form
	I agree to the MERLOT Use Agreement

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