JVS and AP Student Textbook Request Form 2018-19

Student Textbook Request Form 2024-25
1221 Innovation Drive, Suite 219
Whitewater, WI 53190
Phone: (262) 473-1469
Fax: (262) 472-2269
www.jedivirtual.org
Student Textbook Request Form
If you would like JEDI to order materials for your student, please submit this form to confirm the order.
Student Name*

First NameLast Name
Singleton (District will be invoiced for textbook)JVS (Fulltime student)
School District*
Name of Course #1*
The name of the course is located on your student's Course Notification letter.
Please Order All required text and workbooksPlease only order text/workbooks listed in special ordering instructions
Name of Course #2
The name of the course is located on your student's Course Notification letter.
Please Order All required text and workbooksPlease only order text/workbooks listed in special ordering instructions
Special Ordering Instructions
If you don't want all required textbooks/materials ordered, please list what you would like ordered.
Delivery Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of Recipient*

First NameLast Name
Date of Request*

MonthDayYear
Signature

Clear
Additional Notes or Comments
Name of Person Submitting Form*

First NameLast Name
E-mail of Person Submitting Form*
example@example.com
Should be Empty: