BBA/SUMMA Calculator Sales Program Application Form

To apply, print out, fill in, and mail or fax it to:
 SUMMA Program of the MAA
1529 Eighteenth Street, NW
ATTN: Dr. Genevieve Knight, BBA Liaison
Washington, DC 20036
Fax: (202) 265-2384 ph: (202) 319-8473; e-mail: bhawkins@maa.org


Category (check one): School: School District: Professional Development Project:
Name of Applicant:
Size of Target Population
Minority and/or Economically Disadvantaged Percentage:
Contact Person:Title:
Address:
City: State: Zip:
Daytime Phone: Fax: E-mail:
State Tax ID Number:

A copy of your State Tax Exempt Certificate is required to be submitted with PO to avoid payment of taxes.

Unit
(Note all prices are "per calculator")		Number of Teacher Packages (10 units each) (X cost per Teacher Package) for Schools/Districts only Number of Single Units (X cost per Single Unit) for Prof. Development Projects only Total
TI-83 Plus, Reconditioned ($45)    
TOTAL COST
OF ORDER		 $ $    

PERSON CERTIFYING THAT APPLICANT MEETS GUIDELINES
(Superintendent of School District or College/University Administrator)

Name: (Please Print)
Title:
Signature
Date