Application for Account Main Contact * First Name Last Name Email * Phone * (###) ### #### Billing Contact (required unless same as above) First Name Last Name Billing Email (required unless same as above) Billing Phone (required unless same as above) (###) ### #### Business Name * Street Address * City, State, Zip * Years at this Address? * Has present firm ever done business under other names/addresses? * Yes No If so, what were the names and/or addresses? Business Classification * Partnership Corporation Proprietorship Business established * State incorporated and city * How did you hear about CSI? * Who is your CSI sales representative? * If none leave blank CSI sales representative email? Enter if known Are you state sales tax exempt? * Yes No State Sales Tax Exemption # (A copy of state sales tax exemption certificate must be supplied prior to start of work) Do you issue purchase orders? * Yes No Would you like to apply for credit? * Yes No, I will pay COD Thank you for joining the CSI ecosystem! If you are interested in applying for credit, go to: https://www.csi2.com/s/CreditApp.pdfhttps://www.csi2.com/s/CreditApp.pdf
