Donation Form - Mrs. Jan Smith

Help your local teachers get the technology items they need. Please sponsor any item below or make a donation in any amount. Every dollar helps!

See the detailed wishlist for Mrs. Jan Smith and donate online at http://www.digitalwish.com/dw/digitalwish/view_profile?id=89081018040039040

Product ID Title Unit Price Quantity Price 6216 Microsoft LifeCam HD Webcam $39.49 _____ $_________ 4009-10 Lightweight Headphones $79.00 _____ $_________   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.