New Account Set-up
Billing Information
Full Name:
Company Name:
Department:
Billing Address:
City, St, Zip:
Work Phone:
Fax:
E-mail:
Online User ID:
Randy
Linette
Josie
Roland
Joey
House
Ask Me
Salesman #:
A/P Contact:
A/P Fax or Email:
Shipping Information
Shipto Address:
City, St, Zip:
No
Yes
Invoice Copies Needed?
Email
Fax
Mail
Invoices/Statements:
No
Yes
Taxable:
Charge
Prepay
COD
Order Type:
Credit Card
Required:
No
Yes
P.O. Required:
No
Yes
Ns
Dt
Dropship
Shipto Route:
XP
Other
Contract #
10%
15%
20%
25%
Standard
Cost Plus
Discount Type:
Additional Comments and/or Contacts
Submitted by:
TODAY'S OFFICE CENTRE
Your one source for Office Supplies, Furniture and more...Since 1981
