SIS Onboarding

Client Registration Form
Name

First NameLast Name
Email
example@example.com

Company Information
Company Name
Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County
Please enter your company's county.
Phone Number
Please enter your company's phone number.
Federal ID #
DUNS #
Credit Requested

YesNo
Is PO required for payment?

YesNo
Tax Exemption Documents

YesNoPartial
Upload Certificate for Ship to Location.

If you have selected Yes or Partial for the Tax Exemption question, please upload your Ship to Location document. Only files in .PDF, .JPG, or .PNG format may be uploaded.
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Invoicing
Please select an invoicing option:

Invoicing by EmailInvoicing by Portal WebsiteInvoicing by Credit Card

Invoicing by Email
Billing Contact Name

First NameLast Name
Billing Address

Street Address

Street Address Line 2

CityState

Zip Code
Accounts Payable Contact Name

First NameLast Name
Accounts Payable Email
example@example.com
Accounts Payable Phone
Please enter a valid phone number.

Invoicing by Portal Website
Portal Website
Contact Name

First NameLast Name
Contact Email
example@example.com
Contact Phone Number
Please enter a valid phone number.
Special Notes

Invoicing by Credit Card

A Stellar representative will reach out via phone to collect your Credit Card information after your form is submitted and processed.
Contact Name

First NameLast Name
Contact Phone Number
Please enter a valid phone number.

Ship-to Information
Location Name
Location Address

Street Address

Street Address Line 2

CityState

Zip Code
Location Phone Number
Please enter a valid phone number.

Company Officers & Trade References
I will be uploading the information below via file upload.

YesNo
Please upload any Company Officer or Trade References for submission. Do not upload any sensitive information.

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1. Company Officer
Name (Company Officer 1)
Title (Company Officer 1)
Email (Company Officer 1)
example@example.com
Phone Number (Company Officer 1)
Please enter a valid phone number.

2. Company Officer
Name (Company Officer 2)
Title (Company Officer 2)
Email (Company Officer 2)
example@example.com
Phone Number (Company Officer 2)
Please enter a valid phone number.

3. Company Officer
Name (Company Officer 3)
Title (Company Officer 3)
Email (Company Officer 3)
example@example.com
Phone Number (Company Officer 3)
Please enter a valid phone number.

1. Trade References
Name (Trade Reference 1)
Company (Trade Reference 1)
Email (Trade Reference 1)
example@example.com
Phone Number (Trade Reference 1)
Please enter a valid phone number.

2. Trade References
Name (Trade Reference 2)
Company (Trade Reference 2)
Email (Trade Reference 2)
example@example.com
Phone Number (Trade Reference 2)
Please enter a valid phone number.

3. Trade References
Name (Trade Reference 3)
Company (Trade Reference 3)
Email (Trade Reference 3)
example@example.com
Phone Number (Trade Reference 3)
Please enter a valid phone number.

Terms & Conditions
Stellar Industrial Solutions, Inc. Master Service Agreement*
Acceptor's Full Name*
First & Last Name
Title*
Title
Date of Acceptance*

MonthDayYear
Signature

Clear
Should be Empty: