National Technology Services, Inc.
15 Redstone Ridge
Voorhees, NJ 08043
Ph# 856-809-1900      Fax#856-753-7978
					Place Credit Card Below and Copy, Then Sign and Fax Back to (856)753-7978
Date:
Cardholder's Name:
Billing Address of Card:
Business Phone #:
Fax Number:
Ship to Address:
Credit Card:  Visa   MC   AMEX   Discover  (Please circle one)
Card #
Exp. Date:
Federal Tax ID: (EIN or SSN)					Secure code # * :
				*(MC/VS = 3-Digits on back of card; AMEX= 4-Digits on front of card)
PLEASE COMPLETE FOR PERSONAL CARD:
Driver's License #_____________________________________ State_____________________
Home Phone:___________________________________
I, ________________________________________ authorize NATIONAL TECHNOLOGY SERVICES, INC. to  charge my
	Please Print Name
personal or my company credit card, which ever is indicated above, the amount shown below.
No refunds for software products.  Hardware products returned for credit must include all packaging; all hardware and
packaging must be in new condition.  All warranties are manufacturer warranties.  NTS will "book" this transaction if
product(s) are unavailable.
I understand and agree to all of the terms above.				Signature:
				Date:
Amount:				Customer PO # :
				NTS Invoice # :
								Revised 2/24/05
NTS/credit card approval form