USE New Customer - Accounting & Fulfillment Information

New Customer Application

Inventory, Purchasing & Fulfillment
Individual Filling Out Form Name

First NameLast Name
Individual Filling Out Form Email
example@example.com
Company Legal Name
Accounting Information
Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Accounts Payable Contact

First NameLast Name
AP Email
example@example.com
AP Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Accounts Receivable/Trade Spend Contact

First NameLast Name
AR/Trade Spend Email
example@example.com
AR/Trade Spend Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Remittance Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Fulfillment Information
Primary Ship To Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Primary Address Ship To Code - (GLN)
Purchasing Contact

First NameLast Name
Purchasing Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Purchasing Contact Email
example@example.com
Receiving Contact - The Person that sets delivery appointments

First NameLast Name
Receiving Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Receiving Contact Email
example@example.com
Delivery/Receiving Hours
Delivery Hours & Special Delivery Instructions - Lumper, Liftgate, Limitation on truck size etc.
None
PREFERRED PALLET TYPE?
Do you have multiple ship to addresses?
Ship To Address #2

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Address 2 Ship To Code - (GLN/DUNS/DUNS+4)
Ship To Address #2 Purchasing Contact

First NameLast Name
Ship To Address #2 Purchasing Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Ship To Address #2 Purchasing Contact Email
example@example.com
Ship To Address #2 Receiving Contact

First NameLast Name
Ship To Address #2 Receiving Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Ship To Address #2 Receiving Contact Email
example@example.com
Do you have more than 2 ship to addresses?
Ship To Address #3

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Address 3 Ship To Code - (GLN/DUNS/DUNS+4)
Ship To Address #3 Purchasing Contact

First NameLast Name
Ship To Address #3 Purchasing Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Ship To Address #3 Purchasing Contact Email
example@example.com
Ship To Address #3 Receiving Contact

First NameLast Name
Ship To Address #3 Receiving Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Ship To Address #3 Receiving Contact Email
example@example.com
Will the customer order through the poppi Portal or EDI?
Order by Pallet Info

11 pallet minimum per order * 22 pallet max per order * 12PKs = 180 cases/pallet * 12PK 16OZ = 140 cases/pallet * 4PKs (1 tray = six 4PKs) 90 trays/pallet * 540 4PKs/pallet 8PKs (1 tray = three 8PKS) 100 trays /Pallet 300 8PKs/pallet
INITIAL ORDER SKU'S
Should be Empty:

New Customer Application

Accounting Information

Fulfillment Information

Order by Pallet Info