Customer Name
*
Add New Customer
Change Existing Customer
Account originated by Business Development
Discount Schedule (Price Class - Sales Info)
*
M1
M1-9
M2
M1-V
M3
M1-4-V
Distributor
M1-9-V
Export
M1-4-7-V
M2-D
M2-7
M2-7-D
M2-9
M2-V
M2-9-V
Valve
Transducer
Named Discount
M1-4
M1-7
Quote
Quote (Must Input Secondary Discount)
Please Select
None
M1
M2
M3
D
Export
Valve
TD
M1-4
M1-7
M1-9
M1-V
M1-4-V
M1-9-V
M1-4-7-V
M2-D
M2-7
M2-7-D
M2-9
M2-V
M2-9-V
Customer Type/Referable (Type Code - Sales Info)
*
DN Distributor (Non-Refer)
DR Distributor (Refer)
MR Master Distributor (Refer)
VN Valve (Non-Refer)
VR Valve (Refer)
ON OEM (Non-Refer)
PN Parker (Non-Refer)
PR Parker (Refer)
RN Resale (Non-Refer)
RR Resale (Refer)
TN Transducer (Non-Refer)
TR Transducer (Refer)
Regional Sales Manager & Sales Region (Sales Info)
Sales Manager
*
NOSHOK
Mike Howard
Mark Klumpp
Mike Walker
Kevin Buchanan
Scott Mullendore
World Wide Web
David Vargas
Sales Region
*
CORPORATE - Internal Region
GLR - Great Lakes Region
NER - Northeast Region
WR - Western Region
MWR - Midwest Region
SR - Southern Region
WWW - World Wide Web
INR - International Region & Direct WCR - Western Canada
Ship Via (Sales Info)
Please Select
None
ABF Freight
CEVA
Conway Freight
Customer Pick Up
DHL International
FedEx 2Day
FedEx Express Saver
FedEx First Overnight
FedEx Freight Economy
FedEx Freight Priority
FedEx Ground
FedEx Intl Economy
FedEx Intl First
FedEx Intl Priority
FedEx Priority Overnight
FedEx Priority SATURDAY
FedEx Standard Overnight
Other
Saia Motor Freight
TNT
UPS 2nd Day Air
UPS 2n Day Early AM
UPS 3 Day Select
UPS Express
UPS Ground
UPS Ground Residential
UPS Next Day Air
UPS Next Day Early AM
UPS Next Day Saturday
UPS Red Saver
UPS Standard
UPS Worldwide Saver
UPS WW Expedited
UPF Holland
USPS Flat Rate
Weiss-Rohlig
Industrial Market(s) Served (select as many that apply)
*
Other
Automation
Catalog
Defense
Fluid Power
Food & Beverage
HVAC
Industrial
Instrumentation & Control
Marine
Medical
Mining
Oil & Gas
Original Equip. Manufacturer
Pneumatics
PowerGen
Railroad
Reseller
Transportation
Valves
Water/Waste Water
Wholesaler
Territory Exception (Sales Info)
Exception Territory
If the Actual Sales Region is outside of the Regional Sales Manager’s Territory then please select – Exception Territory and list the reason for this exception and the approval information in the comments section below.
Contact(s) to receive Welcome Letter
Add to Distributor Referral List
Yes
Email for Referral List
*
example@example.com
Distributor Referral List Comments
What is the business case/expectations for setting this account up?
*
Sales Forecast for the current year
*
Annual Sales Expectations
*
Have you followed this company and connected with company contacts on LinkedIn?
Yes
Customer Credit Information
Payment Terms Requested
1N30 1% 15 Days - Net 30
N45- Net 45
N60 - Net 60
PRE Cash in Advance
Additional Comments
Submit
Should be Empty: