P.O. Box 1897 * Kennesaw, GA  30156

(Delivery) 5919 Lake Acworth Drive * Acworth, GA  30101

E-mail: NLS@NLSSpecialties.com * www.NLSSpecialties.com

(770) 422-7867    * Voice Mail (770) 529-6242    * Fax (770) 421-9473    *Fax (770) 529-3055

Use black ink if faxing.

Has church ordered previously?  yes ____ no____   Order Date  _______________   Date Needed _______________

Person Ordering  ______________________________________________   Position _______________________

Church Phone  __________________________________ext._______      Church Fax ________________________

Day Phone _______________________________________ext.________    Is that # Work _____ or Home_____?

E-mail address  ________________________________________________

We need Church information before processing any order.  We prefer shipping to the Church.

Church Name  _______________________________________________________________________________

Church Delivery Address    _____________________________________________________________________

Church Billing Address ________________________________________________________________________

Ship to if different than Church: Home  _____ or  Work  _____   

        Street Address   __________________________________________________________________________

        City  _____________________________________     State  _____________________     Zip ________

        County ___________________________________

Method of Payment (Check one):

    ___Church Purchase Order # _________                ___Sent Check # ___________                ___Bill to Church   

     ___Charge Credit Card      ___  Personal          or              ___  Church

                                                   ___  Visa                 or              ___  Mastercard

    Card#  _________________________________________            Exp Date _________________

    If Personal Credit Card used,  give name of Person on Credit Card    _____________________________________

    DAYTIME phone # of person on Credit Card    ____________________________________________________

    Billing address for Credit Card holder Authorization    Street # __________________________   Zip ___________

Tax Exempt #  _____________________________

Security Cards:    This is a 3 3/8" x 2 1/8" size vinyl card with five write-in panels on the back. The panels on the back can be used for parents name, children's names or any important information.  These are given to the parent or person responsible for the child.  For this to be truly effective no one may take the child unless they show the card.

Ordering Options:   

                             Stock Cards- * No minimum * $0.50 each

Make your selection

Teal Imprint / Boy & Girl Quantity:______ @ $0.50 each Total $:__________

Pink / Silhouette Quantity:______ @ $0.50 each Total $:__________

Blue/ Silhouette Quantity:______ @ $0.50 each Total $:__________

The bottom of each card reads "If found please return to Church Preschool Ministry".  It also list how to order more security cards from NLS Specialties.

If you are ordering two or more stock items EX: Kiddie Keepers and Stock Diaper Bag Tags then add one shipping charge to the total order.  Stock shipments are totaled and shipped together from our office.

Order Form For Additional items

We consider it a blessing to be a part of your ministry!!!

Jamie Cardell, Pam Reeves, Christy Godfrey, Deanna Burkhardt and Joy Carlisle