EmailMe Form - Business Information Form

Business Name *

The name of the business submitting purchase orders to us.

Your Name *

First Last

Name of person completing this form.

Email address that will be used to submit POs to us *

This email address will be used for account access on our website. It is also where order confirmation and status updates will be sent.
Each employee whose email address is different than this one will need to complete this form if they are authorized by your company to submit POs.

Purchasing Department Email Address, if different from above

Email address of the purchasing department.

Email address where invoices should be sent. *

This address is where the invoice will initially be sent. Do not enter your email address unless you are responsible for payment or for routing the invoice to AP.

Is the email address you just entered for Accounts Payable? *

YES

NO

Accounts Payable email address

Email address of accounts payable. Reminder invoices, statements, etc. will be sent here.

BILLING ADDRESS

Street Address *

Enter the Street Address.
Do NOT ENTER A COMPANY NAME HERE.
(Put it in the Business Name field.)

Address Line 2

Enter Ste. #, etc., here

City *

State *

Spell out your state. Do not abbreviate.

Zip + 4 *

Enter as #####-####

Country *

Business Phone Number *

### - ### - ####

By completing this form, you acknowledge that the information herein is accurate and you are authorized to provide this information on behalf of your organization. You understand our payment terms are Net 30 unless other terms have been agreed upon by us in writing prior to purchasing.