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REVIVE Customer Setup Form
This form will be forwarded directly to the brand. Please complete with that in mind and be as detailed as possible.
PLEASE INCLUDE:
Your resale certificate
Your completed brand contract (emailed to you)
Please enable JavaScript in your browser to complete this form.
Customer Name
*
default shipping address
Store / Location #
*
Address Line 1
*
Address Line 2
City
*
Zipcode
*
State
*
Territory
*
USA
Canada
default billing address
Name
*
Address Line 1
*
Address Line 2
City
*
Zipcode
*
State
*
Territory
*
USA
Canada
Margin
*
Payment Terms
*
Payment Method
*
Currency
*
Incoterms (contractual shipping terms)
*
SPECIAL SHIPPING INSTRUCTIONS
primary contact (usually an ap contact)
Name
*
Phone
*
Email
*
COPY OF RESALE CERTIFICATE
*
Click or drag a file to this area to upload.
SIGNED AND FILLED BRAND CONTRACT
*
Click or drag a file to this area to upload.
Submit
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