APPLICATION FOR LEASING TI CALCULATORS

Please read and fill out this form completely. Return the form and the money to your mathematics teacher.

Student Name (Please Print)____________________ Student ID____________

Math Class ____________________________Period __________    Teacher_____________________

TI graphing calculators may be leased for the 97-98 school year. Calculators will be issued in working order and must be returned in working order. If a problem exist during the first five days, please return

the calculator to your math teacher for replacement. After this period, if battery replacement is necessary this will be the responsibility of the student. If a calculator is used one semester or less, one half the leasing

fee will be refunded. In case of loss or damage to a calculator, the student will be required to pay the balance for purchasing a new one. Calculators are due for return the day the student finishes the final exam for his math class.

LEASING FEE BALANCE FOR LOSS

TI - 81 $20.00 $40.00

TI - 82 $25.00 $55.00

TI - 83 $30.00 $ 60.00
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I have read and understand the conditions for leasing a calculator.

Student Signature ________________________________

Parent Signature _________________________________

Home Address ___________________________________

Phone Number ___________________________________
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DO NOT WRITE BELOW THIS LINE
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Date of Application__________________ Received by ________________

Calculator Number __________________ Date Out __________________

FEE: Check or Cash $_________________ Date IN ____________________