School District:

School:

Variables

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: . 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
2 / Bag, plastic zip lock 1 quart pk 10 / pack / 1120 / 1.17
2 / Band, rubber #33 pk 25 / pack / 2231 / .97
1 / Clip, paper, small bx 100 / pack / 1720 / 1.31
100 / Cup, 6 oz, paper (must be paper) / each / 1921 / ..08
1 / Foil, aluminum / each / 010-1397 / 4.14
1 / Line, nylon fishing, 10 lb, 630 meters / each / 060-2425 / 4.42
2 / Sandpaper, coarse / each / 192-3712 / 1.17
2 / Stick, craft pk 50 / pack / 1662 / 1.31
1 / Stick, craft, cut pieces, 2 cm pk 100 / pack / 1662A / 2.76
2 / Straw, jumbo, plastic pk 30 / pack / 2267A / 1.31
1 / Straw, super jumbo, plastic pk 50 / pack / 2269A / 2.07
1 / Tape, duct / each / 200-0261 / 6.90
4 / Book, Variables, pk 8 / each / SD542-2023 / 81.42
1 / Clip, paper, jumbo bx 100 / box / SD1708 / 2.42
10 / Corks, large #5 (7/8L x 11/16 diam x 17/32 diam) / each / SD1423 / .83
8 / Flipper angle brace / each / SD060-2337 / 7.18
8 / Flipper, base / each / SD060-2348 / 4.28
16 / Hook, plane / each / SD080-1712 / .41
1 / Poster, safety, grades 5-6 / each / SD161-6317 / 2.21
16 / Propeller (use FOSS) / each / SD161-4029 / 1.00
2 / Punch, hole, single / each / SD1278 / 4.07
8 / Sponge, 4 x 6 / each / SD190-4770 / 1.24
8 / Stopper, rubber #0 / each / SD192-3668 / .39
1 / String, ball 200 feet / each / SD3423 / 2.28
8 / Tape, measuring, metric / each / SD3006 / 2.21

Warehouse: Order picked by______Date______Order checked by______Date______