National Accounts Pre-Qualify
Your Name
*
Your Email
*
example@example.com
Name of company
*
Corporate Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Number of locations
*
Estimate of annual uniform spend
*
Is the customer potentially liable for all locations?
*
Yes
No
If no, we will need documentation for what locations customer is liable for.
Comments regarding request:
Submit
To be completed by person reviewing request
Completed by:
Select one:
51+/100 GREEN FLAG
50 OR BELOW, RED FLAG
QUESTIONABLE
Notes from person reviewing request.
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