Chem Tests School:
School District:
School:
Myself and Others
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 | | |1 |Dot, various colors pk 240 | |pack |1126M |4.14 | | | |6 |Label, 1 x 3 pk 30 | |pack |2152 |1.31 | | | |1 |Paint, tempura, red, 8 oz | |each |PAINT-T |4.14 | | | | |Paper, mural (precut 5' sections, order one per student) | |each |K1010SM |1.04 | | | |1 |Paper, roll, adding machine (white or any color) | |each |3239 |1.73 | | | |8 |Plate, aluminum pie 8" | |each |1240 |1.04 | | |8 | |Bowl, plastic, 16oz | |each |SD1236 |.62 | | |8 | |Crayon, ethnic, box | |box |SD1416E |4.14 | | |16 | |Lens, hand | |each |SD1111 |1.31 | | |8 | |Pad, ink stamp | |each |SD1222 |4.14 | | |16 | |Tray, plastic, cafeteria, 11 x 14" | |each |SD200-4936 |6.21 | | |
Warehouse: Order picked by_____________________ Date___________ Order checked by____________________ Date_________
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