Customer Information Form
Thank you for your interest in San Benito Shutter! We look forward to doing business with you!
Personal Information
First Name Last Name
*
Primary Email
*
example@example.com
Phone Number
*
Business Information
Business Name
*
Commercial or Residential?
Commercial
Residential
Company Website or Social Media URL
Resale Certificate Number
Tax ID Number
*
Projected Annual Revenue:
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Shipping Address (if different from above)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
I would like to apply for credit terms :
Yes
No
How did you hear about us?
Social Media
Another Contractor
Friend or Family Member
Search Engine
Other
Submit
Should be Empty: