Amplify  Free Sample Request.
 (formerly Wireless Generation)                                               

                                             (ALL fields must be completed)

 First Name     Last Name  

 Position      Grade   

 District      

 School
   

 
Address 

 City               State 

 ZIP         
    Phone  

 Email Address  
 This will be the email address we will use to send confirmation of your request for samples.
 
 

 
Have you purchased books from Richard C. Owen Publishers, Inc. before?  Yes  No
 Is Amplify a School initiative?  District initiative?
 Who is responsible for book selections?
         Name
   Title  

 
When do you plan to purchase books?   In the next month or two
         Before the end of this calendar year
   Not sure 
 

   Click Submit when ALL fields are completed
  

 

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