National Technology Services, Inc.
15 Redstone Ridge     Voorhees NJ 08043
Phone: (856) 809-1900    Fax: (856) 753-7978
VAR/OEM APPLICATION
(to be completed and returned along with credit application)
COMPANY NAME             Date:___________________
DBA:            
Date Established:____________________________ Annual Sales: ______________________
Number of Sales Locations:_________ Number of Sales Reps:_____________
Your Marketing Area   Local:       % of Business:____________%
(Please check)   Regional:       % of Business:____________%
  National:       % of Business:____________%
  International:       % of Business:____________%
Product Lines: TOTAL: 100%
Personal Hand Held Data Portable Printer Brands:        
Collection Devices Brands (if any):                
                   
                   
Software:           Software:          
                   
                   
Marketing Information: (vertical market sales)
Primary:                    
Secondary:                    
Other:                    
Customer Profile (please check):
Small Business   % of Sales   %
Corporate   % of Sales   %
Education   % of Sales   %
Government   % of Sales   %
Retail - "no value"   % of Sales   %
Other   % of Sales   %
TOTAL 100%
How do you market your products(I.e., phone, advertising)?              
                       
                       
Terms:  I hereby agree to abide by the terms set forth by National Technology Services (NTS) in the VAR Program
Description.  I further agree to pay any and all attorney fees incurred by NTS in collecting past due balances.
I certify that the information provided in this application is accurate to the best of my knowledge and I fully understand that
false information provided to NTS is grounds for termination of the VAR/OEM Agreement.
Date:______________________ By:          
Print Name:          
Title: