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New Client Setup Form
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Client Information
Company Name
(Required)
Enter the legal name of company that is to be used for contracts and invoicing
Trade Company Name
(Required)
Enter the name of the company that the company does business as.
Enter Your Address Information Below
(Required)
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Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
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Year Established
Tax Exemption Number
Industry Classification
(Required)
Click here for options
Automotive & Automotive Parts
Business Products & Services
Consumer Products & Services
Education & Education Support Services
Financial & Insurance
Food & Beverage Products
Government & Elections
Health Care
Industrial Goods & Services
Legal
Media
Natural Resources
Non-Profit
Personal Care, Drug, and Grocery Stores
Restaurants
Retail
Real Estate
Technology
Telecommunications
Travel & Leisure
Utilities
Other
Choose the best category that describes the primary portion of your business.
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Pattison Account Executive
A copy of your completed form will be returned to the Pattison email above.
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Company Lead Name
Nutshell Company QA Lead Name
This field is hidden when viewing the form
Nutshell Account ID
Nutshell Company Account ID
Client Preferences
Language Preference
(Required)
English
French
Special Invoicing / PO Required?
(Required)
No
Yes
Special Requirements
Please indicate what special invoicing requirements you have (i.e Blanket PO Number, PO Number to be issued with each contract, etc)
Accounting Information
Accounts Payable Contact Name
(Required)
Contact name for invoices or accounting enquiries.
Phone
(Required)
Phone number for accounting contact.
Accounts Payable Email
(Required)
Email address for accounting contact.
Preferred Method of Payment (Select One)
(Required)
Electronic Payment (Credit Card or Bank Transfer)
Cheque in Advance
Electronic Payment Options
(Required)
Credit Card - Please Send Me a DocuSign Envelope to Provide CC Information
Credit Card - Please Call Me to Obtain CC Information
ACH / Bank Transfer - Please Email Me at the Email Above With Details (Business References Required)
Pattison Outdoor accepts Credit Card payment as well as Bank Transfer (ACH) Payments. Please select one of the three options to let us know how you would like to proceed with electronic payments. If you select DocuSign, a secure DocuSign envelope will be sent to you to fill out electronically with your credit card information. If you select Call Me, an individual from our Credit Team will reach out to gather your credit card information. If you select Bank Transfer / Email me, a Credit Team member at Pattison will email you instructions on the bank transfer
Business References
Please list three trade references that we can contact for a credit check.
Name (Reference #1)
(Required)
Company (Ref #1)
(Required)
Phone (Ref #1)
Email (Ref #1)
Name (Reference #2)
Company (Ref #2)
Phone (Ref #2)
Email (Ref #2)
Name (Reference #3)
Company (Ref #3)
Phone (Ref #3)
Email (Ref #3)
Consent
Disclaimer
(Required)
I consent
By providing your consent, you authorize Pattison Outdoor to obtain credit information about my company and ensure the details provided in this form are correct.
Name
(Required)
First
Last
Date
MM slash DD slash YYYY
Contact Email
(Required)
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