1 Step 1

New Customer Form

Organizationyour business name

Contact Name

Title

Phone

Faxyour full name

Email addressa valid email

Street Address

City

Zipcodeyour full name

Do you require purchase orders?

YesNo

Shipping & Billing address the same?

YesNo, they are different

Billing Addressyour full name

Billing City

Billing Zipcode

Are you tax exempt?

YesNo

Upload Exemption FilesUpload References

Upload Exemption Files

Rental References

Please upload a file containing three rental references or fill out the information below. Please be sure that your upload includes Name of Company, Address, Phone, Rental Period, and a brief description of rental.

Upload ReferencesUpload References

Upload References

Company Name

Addresss

Phone

Brief Description of Goods/Services Rentedmore details

0 /

Company Name

Addresss

Phone

Period Rented

Brief Description of Goods/Services Rentedmore details

0 /

Company Name

Addresss

Phone

Period Rented