Precision Machine - Work Request

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After you fill out this order request, we will contact you to go over details and availability.

Email *

First Name *

Last Name *

Check one *

Outside customer

SERSD Staff

SERSD Student

Customer: phone/and or extension number *

Customer Address: street, town & zip code

Please specify what is is you would like to get done: *

Quantity?

CUSTOMER: I understand payment is due in full to picking up job requested.*** Scholarship Fee: In lieu of labor charges a scholarship fee will be applied to the total bill. The scholarship fund assists students with continuing education, tools and supplies. A $5 fee will be applied on orders at $50 and under. Jobs over $50 will be charged 10% of total charges. Enter your name below to indicate you have read and understand the payment policy *

CUSTOMER: I make this disclosure pursuant to G.L.c.268 A,?23 (b)(3) in order to dispel any appearance of potential conflict of interest, that I may be improperly or unduly influenced in the performance of my official duties, or that I would be likely to act or fail to act as a result of kinship, rank, position or the undue influence of any part or person. I publicly Disclose the Following Facts (Please be Specific): * *

I am an employee of Southeastern Regional Vocational Teachnical High School.

I am a student at Southeastern Regional Vocational Technical High School.

I am a parent of a student attending Southeastern Regional Vocational Technical High School.

No conflict of interest.

A copy of your responses will be emailed to the address you provided.

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