Catalog Purchase Form
After filling in the information, please print it on your printer for
future reference.  Then click on the "Submit Order" button at the
bottom of the form to send your order.

Please enter the following information completely.
Name:
Street Address:
City:
State:
ZIP: -
Phone
E-Mail:
Name on Certificate:


Please note all orders will be verified with JONES NCTI
before the order can be honored.
Indiana residents will have 7% sales tax added.
Indicate
Quantity
For Each
Plaque

Master Technician Plaque ------------ $ 45.00 each
 MT - Customer Premises Plaque ---- $ 45.00 each
 MT - HFC Networks Plaque --------- $ 45.00 each
 Senior Master Technician Plaque --- $ 45.00 each

Prices include S&H in continental United States

Shipping & Handling Charges

Orders shipped in the contiguous United States are shipped  by USPS Priority Mail.

Outside the contiguous United States, your order will be shipped per your special instructions, and any shipping charges will be added to your order.


How will you be paying?

Your credit card will not be charged until your order is ready to ship.  Your monthly statement will show the charge from Accurate Laser Works, Inc., not NCTI

Name on card
Billing Address:
Billing ZIP:
Card:
Card Number:
Exp. Date:

  Verification Code:  

You will receive a sales receipt with your order.

Please let us know how best to serve you.

special
Instructions

Please note that if you do not get a confirmation page next,
the order was not processed.