New Client Information Form

Client Registration

TLC Sampling LLC
SECTION 1: COMPANY INFORMATION
Company*

Company NameWebsite
Mailing Address (if different than billing)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
SECTION 2: CONTACT INFORMATION
Contact Name*
Primary Contact
Title/Position*
Contact Work Number*
Work
Contact Cell Number
Cell
Contact Email*
Fax
Alternate Contact Name
Name
Alternate Contact Title/Position
Alternate Contact
Alternate Contact Work Number
Alternate Contact (Work)
Alternate Contact Cell Number
Alternat Contact (Cell)
Alternate Contact Email
Alternate Contact Email
For multiple recipients, please use this one email address
Email
Please name your distributor and the person who is your primary point of contact there:*
SECTION 3: BILLING INFORMATION
Billing Contact*
Name
Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Billing Phone Number*
Billing Phone
Billing Email*
For invoice delivery
PAYMENT ARRANGEMENTS

New suppliers are subject to a one-time registration fee for account set up. This will be added to your first invoice. Invoices are sent out weekly, following any scheduled tastings. Regular Tastings are billed at a rate of $225 each and will include the cost of sample reimbursement. We offer multiple payment options for your convenience.

ACH (on receipt, net 15, net 30), Credit Card, or Bill.com

Please select your preferred payment terms and sign below.

A document will be sent to your billing contact to obtain the applicable billing and account details.

Registration is not complete until that document is returned.
Please choose your preferred payment terms and sign below:*

ACH on receiptACH net 15ACH net 30Credit CardBill.com
Signature*

Clear
SECTION 4: PRODUCTS & MARKETING
Products*

Please upload your product's sales sheets, tech sheets, or any info you can provide to educate our Ambassadors on your product
Cancelof
Retailers/Accounts*

Please provide a list of accounts you want demos scheduled at, or a list of accounts your product has been sold into in the last 6 months if you would like assistance choosing accounts for demos
Cancelof
Company Logo

Please upload your company logo
Cancelof
Marketing Images

Please upload any images you would like us to use for marketing purposes.
Cancelof
SECTION 5: BRAND PREFERENCES
Please list your SKU Prioritization*
In order of preference, which SKUs are to be sampled? TLC Recommends sampling no more than 4 skus per demo
Is there a purchase requirement for accounts to hold a tasting? If yes, how many cases must the account purchase in order to have a tasting?*
Minimum sales expectations*
Minimum # of units you expect to be sold per demo? PLEASE DEFINTE YOUR UNIT (how many in a pack, case, etc)
What do you consider to be exceptional sales?*
How many units sold would be considered AMAZING?
Select which markets you would like your product demoed in:*

NWA (Fayetteville, Bentonville, Rogers, Springdale, Bella Vista)Fort SmithCentral Arkansas (Little Rock, NLR, Sherwood, Maumelle, Cabot, Conway)Other
Should be Empty:

Client Registration

SECTION 1: COMPANY INFORMATION

SECTION 2: CONTACT INFORMATION

SECTION 3: BILLING INFORMATION

SECTION 4: PRODUCTS & MARKETING

SECTION 5: BRAND PREFERENCES