Home Secretarial Services (HSS)

MasterCard/Visa - FAX It or Mail-In Order Form

You can join our team more quickly and conveniently through the use of your credit card. Just print out this form and fax or mail it to HSS.

Name___________________________________________________________

Street Address_________________________________________ Apt________

City ____________________________________________________________

State/Province ___________________ Country____________ Zip___________

Ship to Address:___________________________________________________

E-mail___________@__________________ Phone _____ _____ ___________

Credit Card type (check one): ____ Visa ____ MasterCard

Name on card_____________________________________________________

Card No.___________________________________ Expiration Date_________

Vin Code No. ________ (last three digits in the signature area on back of card)

Card Holder Signature _________________________________ Date ________

Membership (one full year) $72.00 - U.S. Secretaries
Membership (one full year) $32.00 - International Secretaries

Total Amount Due $__________  Initial: ________

FAX to: (614) 986-7234 (24 hours) or Mail your SIGNED order to:

Home Secretarial Services PO BOX 27642 Columbus, OH 43227-0642.