Featured Inventory Request Form

Contact Info
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Purchase Order Number
(optional)
Shipping Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is the Billing Contact the same as above?*

YesNo
Billing Contact Organization Name
Billing Contact Name*

First NameLast Name
Billing Contact Email*
This Email should be your work email and NOT your personal email address.
Billing Contact Phone Number*
This should be a work number and not your personal phone number.
Is the Billing Address the same as above?*

YesNo
Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Where did you hear about us?

Print AdOnline AdNews StoryFriend or FamilySocial MediaReferral from Community OrganizationSearched OnlineOther
Comments, questions, or concerns
Terms and Conditions

While BC Technology for Learning Society is committed to providing functioning
equipment, any subsequent liabilities or repairs are the sole responsibility of the recipient.

I agree that submitting this request does not guarantee available inventory levels and/or that my organization is automatically qualified. All prices displayed above are for estimation purposes only and are by no means considered an invoice.

Prices are subject to change without notice. BC Technology for Learning Society
reserves the right to refuse any request.
I have read and agree to the Terms and Conditions above.*

Yes
Enter the message as it's shown*
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School or Organization Info