SHOES FOR CREWS® - Slip-Resistant Safety Footwear

Welcome to Shoes For Crews! We're proud to be your partner in safety.

Thank you for choosing Shoes For Crews as your partner in safety, For the account to be opened promptly and accurately, please provide the information requested on the form as outlined in the instructions.

Your Shoes For Crews Sales Representative will contact you when the form is submitted for processing.

Thanks!

Please complete and sign this form:

Industry *

Please Specify Other Industry

Please provide your Management company name

I'm most interested in *	Footwear	CrewGuard Overshoes	Mats
Payment Method *	Billable (Net 30) Credit Card (Prepay)	Billable (Net 30) Credit Card (Prepay)	Billable (Net 30) Credit Card (Prepay)

Business Entity Name *
Government Entity Name *
DBA *
Do you have a DUNS Number?
If you have another account with us, please provide an account number(s)
Expected annual purchase for SFC product
Credit $ Limit Requested
# of Employees in footwear program *
# Locations *
»# Locations « You can email the completed spreadsheet to lisas@shoesforcrews.com
How long have you been in business? *
Please email your bank and trade references to lisas@shoesforcrews.com and AR@shoesforcrews.com or click here
»Download Trade References Form «
»Download Bank Release Form «
Is your company Tax Exempt? *
Yes:
Please provide a copy of your certificate by clicking here

No:
Does your company require PO Numbers on invoices? *
Yes
PO Number Type: UNIQUE BLANKET
Please provide a copy of your blanket PO by clicking here

No
Do you have specific shipping requirements? *
Yes
Please provide a copy of your Vendor Guide by clicking here

No
Do you have a Vendor Agreement that needs to be completed? *
Yes
Please provide a copy of your Vendor Agreement by clicking here

No
Which of the following do you fall under?
Merchandise Delivery Method Drop Shipments Stocking Inventory
Contact Name *
Contact Phone*
Tel : Ext :
Contact Email *
Do you have an existing web account?
Yes
Current UserName:

No
Accounts Payable Contact same as above?
Accounts Payable Name *
Accounts Payable Tel/Ext * :
Accounts Payable Email *
Company Address
Main Contact Address
Address *
Address
City *
State/Province *
Postal Code *
Ship to this address ? Yes. Please note that we cannot ship to a Post Office box.
Accounting Mail Address
Address
Address
City
State/Province
Postal Code
Do you have any comments to add to your application?:

By signing below, you acknowledge the following:

You certify all information provided is accurate and true, to the best of your knowledge.
You are authorized to establish a credit account for the above listed company.
You agree to abide by Shoes For Crews Payment terms of NET 30 DAYS.

REFUNDS Billable Customers will be issued refunds in the form of a credit to your company account. For other options, please speak with your sales rep. REFUNDS Pre-Paid Customers will be issued refunds back to the credit card used to purchase the product(s). TAX EXEMPT:Tax exempt customers must provide a copy of their current tax exemption certificate before any orders can be placed. LOCATION LISTINGS: Please click link below to download the preferred template for location listings. Yes. I Agree to these terms
My Name *
My Title *
Date *

Thank you for submitting your agreement online.

Your sales representative, Lisa Stoller - Head of Risk Advisory Services, has been notified and will inform you when the process is complete.

Click here to download a copy of this online agreement for your records.