Election On-line Kit $10 You may print out and complete this form, then fax it to (440) 397-7239.

TEACHER INFORMATION - ELECTION ORDER FORM $10
First Name
Last Name
School Phone (xxx) xxx-xxxx
Email
Valid Email address required in order for us to send your Chronicledition login information.
Grades you teach: (check all that apply)	K-3     4-5     6-8     9-12     Adult Other
Subjects you teach: (check all that apply)	Adult Education   Current Events English/Language Arts   Economics/Business ESL   Journalism/Media Literacy Math   Science Social Studies/History/Civics Special Education   Other
Will you be accessing Chronicledition from a classroom or library?	Classroom     Other
School Name
School District
School Address
City
State
Zip
From time to time, we will send you email announcements on new featured programs, products and services from the Chronicle-Telegram NIE. Please note: To opt out of receiving emails from NIE prevent participation in specific programs. Please click here to opt out if you do not wish to be contacted directly by a NIE Representative. Information is used soley for The Chronicle's NIE program and will not be shared with outside vendors.
ORDER INFORMATION - Note: All fields must be completed to process your order!
Start Date (example 09/01/2008)	(May take up to 3 days to process your order.)
Last Day of Delivery
Enter the number of student licenses (newspapers) for each day of the week. One license per student per day. High School teachers enter your largest class number. Be sure to include yourself . Sunday papers 65 cents, 5 days a week.
Monday   Tuesday   Wednesday   Thursday   Friday
Please indicate any holidays or in-service dates (please use specific dates).
Click to submit. You will be sent a confirmation. Chronicledition will begin within 3 days. Orders received on Saturday or Sunday will not be processed until that following Monday.