Page 1

TI- Nspire CAS Handheld Calculator with Touchpad & Computer Software Package 2011-2012 Order Form This form and Payment due to HC Business Office no later than 8/15/2011

Calculators will be distributed during the first week of class for those students who have paid by the due date above. Cost of Calculator including required software and sales tax - $140 Student’s Name _______________________________________________Grade___________ Parent/Guardian Name(s)_______________________________________Date____________ Home Phone ______________________ Work Phone ______________________ Method of Payment: _____Cash

_____Check # _____payable to HCHS

_____Credit Card, I authorize Houston Christian High School to charge the credit card below Name on card (please print): _____________________________________________________ Billing address:________________________________________________________________ MC __ Visa __ Card Number: ________________________________Verification #:_______ (last 3 digits on back of credit card) Expiration Date:____________Signature: _________________________________________ Please return this form to the Business Office with payment attached. Thank you!