SHOES FOR CREWS® - Slip-Resistant Safety Footwear

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Lisa Stoller - Head of Risk Advisory Services
Phone: 1-800-218-4770 x5121
Email: lisas@shoesforcrews.com

Status:

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

*
Payment method for each

Footwear	CrewGuard Overshoes	Mats
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 *

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 No

Please provide a copy of your certificate by clicking here

Does your company require PO Numbers on invoices? *

Yes No

PO Number Type: UNIQUE BLANKET

Please provide a copy of your blanket PO by clicking here

Do you have specific shipping requirements? *

Yes No

Please provide a copy of your Vendor Guide by clicking here

Do you have a Vendor Agreement that needs to be completed? *

Yes No

Please provide a copy of your Vendor Agreement by clicking here

Which of the following do you fall under?

Merchandise Delivery Method Drop Shipments Stocking Inventory

Do you have an existing web account?

Yes No

Current UserName:

Primary Contact

Contact Name *

Contact Phone and Extension * :

Contact Email *

Yes, please send me e-mails with special offers, coupons, updates and promotions from Shoes For Crews.

Accounts Payable Contact

Accounts Payable Contact same as above?

Accounts Payable Name *

Accounts Payable Tel/Ext * :

Accounts Payable Email *

Yes, please send me e-mails with special offers, coupons, updates and promotions from Shoes For Crews.

Does your company have specific billing requirements?

Billing Address

Billing Postal Code *

State *

Billing City *

Billing Address *

Address 2 (Apt., Suite, etc.)

Shipping Address

Shipping Address
(Please note that we cannot ship to a Post Office box.) same as above?

Shipping Postal Code *

State *

Billing City *

Billing Address *

Address 2 (Apt., Suite, etc.)

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 an account for the above listed Entity.
You agree to abide by Shoes For Crews Payment terms of NET 30 DAYS.
Payment terms are NET 30 days or based on the Contract between SFC and your Entity.

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 *

I'm most interested in

What are your primary interests for opening this account? Choose at least one.

Select Payment Method

Choose a preferred payment method for each interest you selected.

This would be the official business name

Example: ABC Restaurants, Inc

DBA (Doing Business As) ?

Example: ABC Restaurants, Inc (DBA Alpha Bites)

Where is your main office located?

Example ABC Restaurants, Inc is located in West Palm Beach, FL but has restaurants in FL, GA, LA, MI, etc

What address is your mail delivered to?

The physical address would be the Company's street address. This is where packages are delivered but mail cannot

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.

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