Assessment Program Application

Earn up to $1500 cashback for your school! All it takes is a few moments of class time to allow students to complete a brief on-line survey before the instruction begins, followed by a post-instruction survey after each unit is completed (Books 1, 2, and 3).

Please complete this form to register for the 2019-2020 academic year. Deadline for applications is September 30, 2019. Click here for incentive program details…

City State

Name (first & last) Job title:
Phone Email

Scheduling Information

Expected instructional schedule:

Principles & Choices Book Instruction Begins Instruction Ends
Book 1: Identity and Values
Book 2: Truth and Reason
Book 3: Ethics and Justice

Expected assessment schedule (include approximate dates and number of students expected to complete assessments):

Assessment Instrument Date Estimated number of students
Teacher Evaluation      

We expect to complete all P&C assessments eligible for rebates by December 31, 2019.We request a later date for completing P&C assessments that are eligible for rebates. Please contact me for scheduling details.

Purchase Information

Yes! Please include my 15% discount!No

Yes, please send me a discount code to share with students.No

Complete this section for past purchases or planned purchases from a distributor:
Do your students use ebooks or print books? Purchased from:      
Print books      

Approximate date of purchase and quantity of each book:

Principles & Choices Book Date of purchase Quantity
Book 1: Identity and Values
Book 2: Truth and Reason
Book 3: Ethics and Justice

Please note:

1. In cases where the stated quantity purchased from distributors substantially differs from the quantity reported to Principles & Choices by these distributors, Principles & Choices reserves the right to request proof of purchase from the school before honoring the incentive agreement.

2. Schools and/or students who purchase used books and/or new books from third-party sellers other than Follett or MBS may be ineligible for assessment program rebates.


My school agrees to participate in the Principles & Choices Assessment Program, according to all the terms and conditions explained on the “15+15 Cashback Incentive Program” Web page, in exchange for a 15% percent discount on the purchase price of textbooks and/or a cash rebate. I understand that failure to complete the assessment program as described in the instruction document will result in cancellation of the incentive offer: no cash rebates will be paid and my school will be required to refund to Principles & Choices any discounts received.

Signature (full name) Job title:

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