| Product ID | Title | Unit Price | Quantity | Price |
| HP-C14 | HP Chromebook 14 (Needs 24) | $189.00 | _____ | $_________ |
| DAV-AIO | XYZPrinting da Vinci 1.0 AiO - All in One - 3D Classroom Printer & Scanner | $899.00 | _____ | $_________ |
| 4013-TEMP | Spirit Listening Center with Sound Alert | $299.00 | _____ | $_________ |
| 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.