HYPEMILL:SWANSAN:SET UP AND CREDIT CARD FORMS

SWANSON NEW CUSTOMER SET UP

CUSTOMER INFORMATION

DATE:

BILL TO:

CUSTOMER NAME:

STREET ADDRESS:

CITY:

STATE:

ZIP CODE:

DATE ESTABLISHED:

EMAIL ADDRESS:

PHONE NUMBER:

FAX NUMBER

CATEGORY CHECKLIST

PLEASE INDICATE THE CUSTOMER ACCOUNT TYPE FROM THE CATEGORY LIST BELOW.

CO-OP

INTERNET/CATALOG

ELECTRIC SUPPLY

LIQUIDATION

FARM

MASS MERCHANT

GENERAL RETAIL

OEM

INDUSTRIAL

SERVICE GROUP

INSTITUTIONAL

STAFDA

INTERNET

TWO-STEP DIST.

OTHER:

PLEASE EXPLAIN:_______________________________

PRICING

SPECIAL PRICING:

YES NO

IF YES PLEASE EXPLAIN

REGIONAL SALES DIRECTOR NAME

SALES REP AGENCY

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