To order a NetDay kit or a NetDay toolkit, print this form and fill
out the requested information, and fax or mail the form to the
appropriate kit provider.
Remember, providers
cannot deliver kits to a school until they receive payment or a
purchase order.
NetDay
Wiring Kit Order
| _____ |
kits @ $_____ |
$______________ |
| _____ |
plenum kits @ $_____ |
$______________ |
| _____ |
toolkits @ $_____ |
$______________ |
| TOTAL |
$______________ |
Sponsor
Information
| ___ sponsoring
as an individual |
| ___ sponsoring
on behalf of an organization or company |
| Company
name |
|
| Company
contact |
|
| Title |
|
| E-mail |
|
| Address |
|
| City,
state, zip |
|
| Day
phone |
|
| Type
of Payment |
|
School
Information
| School
name |
|
| E-mail |
|
| Address |
|
| City,
state, zip |
|
| Phone |
|
| Purchase
Order # |
|
NetDay
School Organizer Information
| Name |
|
| Employer |
|
| E-mail |
|
| Address |
|
| City,
state, zip |
|
| Daytime
phone |
|
|