New Client Set Up Form WHO IS YOUR BRAND AMBASSADOR?(WHO DID YOU SPEAK TO AT ITB?) Who is your Brand Ambassador? I'm not sure Dan Reading Lori Reading Megan Little Company Name: Industry: Main Contact Name: Main Contact Email: Main Contact Phone: Main Contact Title: Accounts Payable Name: Accounts Payable Email: Accounts Payable Phone: Billing Address: City: State: State* Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip: Fax: Shipping Same As Billing? Shipping is Same as Billing Shipping Address: City: State: State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip: Fax: IS YOUR COMPANY TAX EXEMPT?If yes, please upload your ST-101 form Is your company tax exempt? No Yes ST-101 Payment Method: Credit Card (Card will be securely on file. Invoices will be emailed and card will be charged the following business day) Net 15 Day Terms (Invoices to be paid via check, cash, or EFT within 15 days of invoice date. (Business trade references required)) CREDIT CARD: We will call you to get your credit card information securely. Credit Card Authorization I authorize In the Bag Promotions, Inc. to charge my card (encrypted and securely on file) upon shipment of order NET 15: Upload Your Business Trade References or Fill Out Below Upload References Business Trade Reference 1: Reference 1 Name Email Address Fax Business Trade Reference 2: Reference 2 Name Email Address Fax Business Trade Reference 3: Reference 3 Name Email Address Fax Contact References Authorization I authorize In the Bag Promotions, Inc. to contact the business/trade references I have provided. Disclaimer Claims arising from invoice discrepancies must be made within seven working days SUBMIT
