Chem Tests School:



School District:      

School:      

Motion and Design

Teacher:      

Month & Year kit will be taught:      

Fill in your order on the computer screen (TAB key moves the curser), SAVE the completed order on your computer and ATTACH the saved order to an e-mail addressed to: Warehouse@. Important: Do not save the form for future use. Use a fresh download from the SEPARSI web site each time you submit a new order. WARNING: small parts are a choking hazard. Adult supervision is required. See SEPARSI web page. Form: 2012-13

*SDur |*Con |(*Sdur=Semi-Durable item; *Con=Consumable item; *This number is given here only to indicate the quantity of items in a new kit for 30 students. Do not use this number as a multiplier for ordering items.) |Order |Unit | ID |Prices |Filled | | |4 |Band, rubber #14 pk 25 |      |pack |1833 |.97 | | | |2 |Band, rubber #64 pk 25 |      |pack |3029 |1.24 | | | |1 |Cardboard (tablet back) 8 1/2 x 11 pk 10 |      |pack |3031 |2.69 | | | |10 |Cup, 1 oz, plastic |      |each |1917 |.06 | | | |1 |Dot, red, blue, green 60 each |      |pack |3025 |2.07 | | | |1 |Paper, graph, (1/4" squares) 3 hole, notebook pk 100 |      |pack |3009 |6.21 | | | |3 |Paper, roll, adding machine, white, or any color |      |each |3239 |1.73 | | |20 | |Block, wood (2 x 2) |      |each |SD3023 |2.29 | | |10 | |Bookend, nonslip base, small |      |each |SD3018 |5.45 | | |15 | |Book, Investigation, Mot & Design |      |each |SD3003B |10.97 | | | | |Book, Kids Discover, Wright Brothers, pk 8 |      |pack |SD3098 |54.77 | | | | |Book, STC Mot & Design pk 8 |      |pack |SD3096 |172.50 | | |1 | |Clip, paper, jumbo bx 100 |      |box |SD1708 |2.42 | | |25 | |Eyelet, bushing |      |each |SD3032 |.17 | | |1 | |Goggle, safety (STC lists as optional) |      |each |SD2160 |4.07 | | |11 | |Hook, screw |      |each |SD3037 |.41 | | |1 | |K'NEX building pieces |      |each |SD3005 |372.53 | | |11 | |Lid, pail plastic 1 gal |      |each |SD1159 |2.69 | | |1 | |Line, nylon braided casting, 60 yds |      |each |SD2222 |6.14 | | |1 | |Marker, fine-point, black, permanent |      |each |SD2572 |2.07 | | |11 | |Pail, plastic 1 gal |      |each |SD1158 |5.45 | | |10 | |Pencils, colored, set |      |set |SD3007 |4.07 | | |11 | |Propeller (use STC) |      |each |SD3035 |1.01 | | |10 | |Tape, measuring, metric |      |each |SD3006 |2.21 | | |1 | |Template, circle |      |each |SD3011 |6.90 | | |10 | |Timer, with batteries |      |each |SD3021 |6.90 | | | | |Battery, for timer (UCC392, Renata 2, Toshiba LR41) |      |each |SD3021A |1.73 | | |1 | |Washer, steel, large pack 30 |      |pack |SD3013 |10.28 | | |1 | |Washer, steel, small, pack 220 |      |pack |SD3015 |8.21 | | |

Warehouse: Order picked by_____________________ Date___________ Order checked by____________________ Date_________

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