New Account Application Customer Name* Customer Type Retail National AccountEcommerceDistributorGovernmentIndependent Retailer Business Contact Information Company Name* Billing Address* Company Tax ID (EIN)* Company D&B* Company Phone Number* Buyer Contact Information Buyer Name* Buyer Email* Buyer Phone Number* Distributor - Do you currently have a purchasing relationship with a distributor Distributor Name Distributor Contact Name Distributor Email Credit Information Net Terms Due upon receipt (customers must apply for credit terms after the 1st order)Net30 Credit -If you select yes, please see the credit application form here. YesNo Class of Customer Health and BeautySight LossArts and GraphicsIndustry & InspectionEcommerceSewing & Crafts Freight Charges Charge to customer's freight accountDelivered (freight included in customer pricing)Bill freight to customer on invoice Freight Terms* Accounting Accounting Contact Name* Accounting Email Address* Accounting Phone Number* Invoice Email Address* Shipping Shipping Address* Shipping Contact Name Shipping Phone Number Shipping Email Address* Freight Carrier Carrier* Freight Number* Hours of Operation* Is Lift Gate Necessary at your Delivery Point* Logistics Logistics Contact* Logistics Contact Email* Logistics Contact Phone* PO Issues/Concerns Backorder/Short Ship Contact* Backorder/Short Ship Email* Backorder/Short Ship Phone* Marketing Marketing Contact* Marketing Email* Marketing Phone* Contract Contract Contact* Contract Email* Contract Phone* Images/Copy Contact* Email* Phone* Business Notes Slotting Fees? Other? Damages % Advertising Coop % Company Information Who do you sell to? What platforms do you sell on? What other names do you sell product under?