| Product ID | Title | Unit Price | Quantity | Price |
| N-CPB500 | Nikon - COOLPIX B500 16.0-Megapixel Digital Camera | $299.99 | _____ | $_________ |
| 251092 | Panasonic Lumix Micro 4/3 Telephoto Lens | $449.00 | _____ | $_________ |
| SD-SDM64 | SanDisk Extreme 64GB microSDXC for GoPro Cameras | $19.95 | _____ | $_________ |
| SP 100 | Olympus Stylus Long Zoom SP 100 Digital Camera | $399.99 | _____ | $_________ |
| Cash Donation (Any Amount) | ||||
| Shipping (8%): | $_________ | |||
| Tax (5%, Vermont Only): | $_________ | |||
| Total: | $_________ | |||
Credit Card (circle one) Visa Mastercard Amex Discover
Credit Card #: ____________________________________
Expiration Date:____/_____ CVV2* Code:______________
Exact Name on Card: ______________________________
Phone: ______________________________
E-mail Address: ______________________________
Credit Card Billing Address:
______________________________________________
______________________________________________
______________________________________________
Please make all checks payable to "Digital Wish". Please return payment along with this form to the appropriate teacher. Or mail with payment to:
Digital Wish
PO Box 255
Milton, DE 19968
For more information on these products, or to purchase online, visit http://www.digitalwish.org, or call (866) 344-7758.