Program Coordinator/Principal name- This should be the person software is being shipped to:	[required]
School name:	[required]
School Address:	[required]
School Shipping Address (can not ship to a PO box)	[required]
Phone:	[required]
School FAX- This number will be used by Ahrens Foundation to FAX you the AutoDesk agreement and final invoice :	[required]
City:	[required]
State:	Wisconsin Minnesota IOWA
Zip:	[required]
Coordinator/Principal e-mail address:	[required]
Purchase Order Number	[required - type "invoice asap" of you have no PO number]
Technology/Engineering Instr. Name	[required]
Technology/Engineering Instr. EMAIL	[required]
How did you find us?	Ahrensfund.org Web Site Purchased Last Year WTEA Web Site Mailing or FLyer [required]
Is your school a Project Lead the Way School	Yes or No (check one)
Number of Leases	Please Select the number of Leases/School Purchases 1 2 3 4 5 6 7 [required] And verify PLTW Status Please Select PLTW status Yes! - PLTW School** Lease ** No - We are not a PLTW school, Annual ADA lease ($3,800 plus shipping) - lease agreement needed PLTW School purchase ($11,620 plus shipping) NON-PLTW - Purchase special* ($9,493 plus shipping) [required @ Annual ADA lease ($3,800 plus shipping) or @PLTW  ADA lease ($3,195 plus shipping) or Purchase special* ($9,493 plus shipping) or PLTW purchase ($11,620 plus shipping) Software version Please Select autodesk version YES - Network version No - Standalone Version
	*Purchase special is for limited time for non-PLTW schools only.  Call 608-577-5954 for details.
Approximate Total Purchase	$

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