Virginia
Internet High School
eClassroom
Order Form


Items marked with a must be filled in or answered completely in order to process your order, When all items are completed press the "Submit My Order" button at the bottom of the page.  If you want to start over, press the "Clear" button to clear your responses.

NOTE:  Each teacher wishing to rent an eClassroom must complete a separate "order form" and, because of reduced pricing for addtional sections, may only rent enough eClassrooms to equal their teaching assignments.

Please fill-in this section completely.  All fields must be completed.

  Purchase Order #: 
  School Division:   
  Home School:       
  Street Address:    
  City:             , State   Zip: 


 eClassroom Renter Information
  Teacher's Name:   
  Title to be used in the eClassroom(s): (Mr., Mrs., Miss, Ms., Dr.) 
  Periods Taught:     # of Preparations    Phone # 
  E-Mail Address:

 Type in the number of eClassrooms desired for each course.  If a course being taught is not listed, enter its department, course name, four-digit state course code, and the number of sections desired in the "Other" space below.
   English
      English 9  English 10  English 11  English 12

   Social Studies
      World History  World Geography  US History 11  US Government

   Math
      Algebra I  Geometry  Algebra II  Trigonometry
      Math Analysis  AP Calculus

   Science
      Earth Science  Biology I  Chemistry  Physics

   Languages
      Spanish 1  Spanish 2  Spanish 3  Spanish 4
      French 1  French 2  French 3  French 4
      Latin 1  Latin 2  Latin 3  Latin 4

   Business & Information Technology
      Accounting  Adv Accounting  Business Marketing  Business Management
      Computer Application  Keyboarding  Office Administration  Word Processing

   Physical Education
      Phy Ed/Health 9  Phy Ed/Health 10  Driver Education

   Careers & Technology Education
      Ag Mechanics 1  Ag Mechanics 2  Ag Business 3  Ag Business 4
      Drafting 1  Drafting 2  ICT I  ICT II
      Resource Management  Parenting  Life Planning
      Health Occupations  Health Assistant 1  Health Assistant 2  Nursing Asst. 1 & 2
      Tech Foundations  Tech Transfer  Prin of Technology 1  Prin of Technology 2

   Fine Arts
      Art 1  Art 2  Art 3  Art 4
      Band 1  Band 2  Band 3  Band 4
      Chorus 1  Chorus 2  Chorus 3  Chorus 4

   Unlisted -- Enter the department, course name, four-digit state position code, and the number of sections desired
    Other #1   
    Other #2   
    Other #3   
 

 Calculating your annual eClassroom Costs
     Total eClassrooms Ordered: 
     First Classroom:  Enter $120 ...................................  
     Additional Classrooms:  Multiply the # times $12 and enter total 
     Total Cost of my eClassrooms :..................................
If everything is correct and to your liking, you are ready to submit your order. As soon as the Internet Schools receives your Purchase Order you will be notified of your User ID and Password for admittance.to your newly created eClassroom(s) and the online "How To" class.

Address all ordering questions to the Virginia Internet High School

Copyright © January 2002 Internet High School Inc.