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  | 
                 | 
             
           
           
          
  |