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Customer Profile

 

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                                                    Customer Profile Form

In an effort to keep our Customer database records up-to-date with your latest Company and Contact information, we are requesting a few moments of your time to assist us by completing the Customer Profile Form.

If your Company’s End-User, Product Shipping and Invoicing Information is the same, then please complete SECTION A only; otherwise, please complete all sections in full.

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Customer / End-User Information: Section A

Company Name:

Contact Name:

Company Email Address:

Company Phone #:

Company Fax #:

Address:

City/Town:

Province/State:

Zip/Postal Code:

Company URL/Web Site:

Product Shipping Information: Section B

Company Name:

Shipping Contact:

Shipping Contact Email Address:

Shipping Contact Phone #:

Shipping Contact Fax #:

Shipping Address:

City/Town:

Province/State:

Zip/Postal Code:

Invoicing Information: Section C

Company Name:

Invoicing Contact:

Invoicing Contact Email Address:

Invoicing Contact Phone #:

Invoicing Contact Fax #:

Invoicing Address:

City/Town:

Province/State:

Zip/Postal Code:

By keeping our customer database records up-to-date with the latest information, we will be better able to assist you with timely customer support, distribution of Marketing information.

THANK YOU, once again!

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