GRAVITY FORM

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.

Address(Required)

Street Address Address Line 2 City Province Postal Code

Year Established

Year business was established

Tax Exemption Number

Tax Exemption number (if applicable)

Industry Classification(Required)

Choose the best category that describes the primary portion of your business.

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Pattison Contact Person

Contact person of individual requesting CSF Form URL

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Company Lead Name

Nutshell Company QA Lead Name

Client Preferences

Language Preference

English

French

Special Invoicing / PO 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.

Email(Required)

Email address for accounting contact.

Preferred Method of Payment (Select One)(Required)

Credit Card

EFT

Cheque in Advance

If Cheque in Advance or Credit Card is selected, a credit bureau report will not be requested.

We do not accept credit card information via email or this form. Please contact your sales rep with your credit card information, or call our head office and ask to speak to our credit team directly at 905-282-6800

Business References

Please list three trade references that we can contact for a credit check.

Name (Reference #1)

Company (Reference #1)(Required)

Phone (Reference #1)

Name (Reference #2)

Company (Reference #2)(Required)

Phone (Reference #2)

Name (Reference #3)

Company (Reference #3)(Required)

Phone (Reference #3)

Name(Required)

First Last

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Date

New Client Setup Form

Client Information

Client Preferences

Accounting Information

Business References

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