New Customer Setup

Division*

Market Channel*

Is this a new customer?*

Did this customer submit a website RFQ?*

CUSTOMER POC (Marketing)

First Name*

Last Name*

Email Address*

Second Contact: First Name

Second Contact: Last Name

Second Contact: Email Address

CUSTOMER INFORMATION

Full Name

Address

City

State/Province*

Zip Code

Phone Number*

Alternate Phone Number

Fax Number

Add Dropship Location?

Yes

No

ADDITIONAL LOCATIONS

Bill to Address*

Same as Above

Add new "Bill to" Address

Bill To*

BILL TO ADDRESS

Full Name

Address

City

State/Province

Zip Code

LOCATION #2

Full Name

Address

City

State/Province

Zip Code

LOCATION #3

Full Name

Address

City

State/Province

Zip Code

LOCATION #4

Full Name

Address

City

State/Province

Zip Code

CUSTOMER ACCOUNTS PAYABLE INFORMATION

Accounts Payable Email Address

Credit Terms

SALES REP INFO

ACCOUNT MANAGER

Account Manager*

ACCOUNT MANAGER #2

Account Manager #2

EMAIL

Packing List Email Address

PACKING LIST will be sent to the above EMAIL ADDRESS

Invoice Email Address

INVOICE will be sent to the above EMAIL ADDRESS

Confirmation Email Address

CONFIRMATION will be sent to the above EMAIL ADDRESS

Shipping Notification Email Address

SHIPPING NOTIFICATION will be sent to the above EMAIL ADDRESS

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