BalancePlus Account Information

Account Information
IncorporatedLimitedPartnershipSole ProprietorshipCurling ClubAssociations & Federations
Legal (Corporate) Name*
Trade Name (if applicable)
Shipping Address*

Shipping Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Billing Address (if different than above)

Shipping Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Business Number/Tax ID #*
Primary Contact Name*
Primary Telephone #*
Format: (000) 000-0000.
Primary Fax #
Format: (000) 000-0000.
Primary Email*
example@example.com
Additional Contact Name
Additional Contact Telephone #
Additional Contact Email
Website*
Accounts Payable Name*
Accounts Payable Email*
example@example.com
Years in Business*
# of Employees*
Owner's Name*
Telephone #*
Format: (000) 000-0000.
Mobile #*
Format: (000) 000-0000.
Home Address*

Shipping Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Storefront/BuildingMobile Visit/Pop-Up StoreOnline/E-Commerce
# of Sheets of Ice
# of Club Members

Total
Signature*

I have authority to bind this entity
Date*
Should be Empty: