General Company Contacts
Name of Company
*
Account Principal and/or Owner
*
Additional Account Manager(s) (for managing employee contact and account access information with Continental Laundry Solutions
Leads Contact (only 1 per company)
*
Shipping Notifications Contact (only 1 per company)
*
Company Contacts
Account Principal or Owner Signature
*
Printed Name & Title
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Should be Empty: