Tel: (226) 224-8666
forestcityposts.com
[email protected]
New
Customer Form
All information contained herein is for our office use only and will not be shared, traded or sold.
WELCOME! THIS IS NOT A CONTRACT! IF YOU ARE UNHAPPY WITH ANY PART OF OUR SERVICE, PLEASE DON’T HESITATE TO LET US KNOW, HOWEVER
WE RESPECT YOUR RIGHT TO GO ELSEWHERE!
________________________________________________________________________
Agent’s Name: _______________________________________________________________________
Company Name / Brokerage Address: ____________________________________________________
Billing address (If different from above): ATTN: ____________________________________________
City: _____________________________ Postal Code: _____________________________________
Business Phone: ____________________ Cell Phone: _____________________________________
E-mail Address: ______________________________________________________________________
Would you like your invoices sent via e-mail, or post mail? ________________________________
Bill direct or through office? ____________
________________________________________________________________________
Payment
by Visa & MasterCard:
Credit Card # _______________________________________ Expiry date (MM/YY) ____/____
Name as it appears on credit card: _____________________________________________________
Postal
Code (from credit card billing
address):___________________________________________
All billing will be automatic; statements will continue to
be sent on a monthly basis as
“paid”.
________________________________________________________________________
Signature:
_______________________________________________
“Thank you for your business, and please don’t keep our company a secret!”
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