Electronic Purchase Order (EPO) Form
. . . a new and convenient way to make your purchases . . .


Pardon Us: . Are you referencing prices currently offered by NSI? The only valid sources for pricing are found at our web page or from a company prepared quotation. . If you do not have either please take a moment to call our home office at 800.495.8808.

Do you use credit cards to make purchases? Click here. to read about The "X" File Advantage program - where participants automatically earn X-TRA savings on product purchases made through NSI.

SECTION I.
[If you've previously ordered through NSI and billing info. is the same, skip this section.]

Bill To Information
How Do You Buy:
.......................Per Agreed Terms .........Credit Card .........Both
Company Name:
Reseller No. (if applicable) :
Buyer Contact:
Tel.: Fax:
A/P Contact:
Tel.: Fax:
Street Address:
City: State:
Zip Code:
County: MS/Floor:
CC On File:
...............NO ....YES (specify card) : ....VISA ...MASTERCARD
Exp. Date/Signer:
 ..............mm/yy:.. ..... Authorized Signer: ..
Other:



SECTION II.

Ship To Information
Company Name:
Contact: Tel.:
Street Address:
City: State:
Zip Code:
County: MS/Floor:
Ship Via:
Date Required: Date Promised:
Other:



SECTION III.

Items Purchased Under This Purchase Order
Buy:
Per Agreed Terms ......Credit Card+Accelerator Discount
P.O. Number: P.O. Date: NSI Quotation No.:
Other:
Do You Want Confirmation That Your Order Has Been Received?
Confirm By:
Telephone Call ...........................E-mail ...........................Both
Contact:
Tele.: E-mail:
Other:

Model Number
Product Nomenclature/Description
Qty.
Your Price
Extended