New Customer Contact Information Form
Accounting, Inventory, Purchasing, Fulfillment
Your Name:
*
First Name
Last Name
Your Email:
*
example@example.com
Company Legal Name:
*
Company Legal Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Company Billing Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Ship to Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Address Ship to Code (GLN/DUNS/DUNS+4)
Do you have multiple ship to addresses?
Yes
No
If yes, please upload DC/FC shipping addresses:
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Accounts Payable Contact Info
*
First Name
Last Name
Accounts Payable Phone Number
*
Please enter a valid phone number.
Accounts Payable Email
*
example@example.com
Accounts Receivable/Trade Spend Contact Info
*
First Name
Last Name
Accounts Receivable/Trade Spend Phone Number
*
Please enter a valid phone number.
Accounts Receivable/Trade Spend Email
*
example@example.com
Inventory Manager Contact Info (person who places the PO)
*
First Name
Last Name
Inventory Manager Phone Number
*
Please enter a valid phone number.
Inventory Manager Email
*
example@example.com
Receiving Coordinator Contact Info (person who sets delivery apts)
*
First Name
Last Name
Receiving Coordinator Phone Number
*
Please enter a valid phone number.
Receiving Coordinator Email
*
example@example.com
Delivery/Receiving Hours:
*
Do you have a vendor or routing guide?
*
Yes
No
If yes, please attached vendor/routing guide.
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Do you have special delivery instructions? (lift gate, limitations on truck size, etc.)
Do you require a lumper?
Yes
No
Preferred Pallet Type?
GMA
CHEP
PECO
IGPS
Other
Does your company have EDI capability?
*
No, we will use poppi order entry portal
Yes, but not required, we will use poppi order entry portal
Yes, we required EDI
Contact that will use the poppi order entry portal?
First Name
Last Name
Contact Phone Number
Please enter a valid phone number.
Contact Email
example@example.com
EDI Contact Information
First Name
Last Name
EDI Contact Phone Number
Please enter a valid phone number.
EDI Contact Email
example@example.com
Vendor Number Assigned to poppi
What is your test qualifier?
What is your test ISA ID?
What is your test GS ID?
What is your production qualifier?
What is your production ISA ID?
What is your production GS ID?
Do you require Case Labels?
Yes
No
Do you require Pallet Labels?
Yes
No
Submit
Should be Empty: