Customer Sign-up Form - Colman Mfg.

Name
Title
Organization
Type of Industry
Account No.
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
FAX
E-mail	(REQUIRED)
URL

System Requirements Microsoft Internet Explorer 5.5 or greater or Netscape 7.0 or greater required. Java virtual machine required. If you do not have the Java virtual machine, you can download and install it from http://java.com/en/index.jsp We recommend Microsoft Internet Explorer 6.0 with the Java Virtual Machine installed on a computer running at least 400MHz processor and 128MB memory connected to the internet with cable, DSL or some type of broadband connection. We are sorry, but at this time there is no support for the Macintosh type operating systems. Please call 877-349-4640 to report any errors or problems you may experience.

Please provide your Employer Identification Number or your Social Security Number if not incorporated. (REQUIRED)

How did you find out about us? (Referral, Website, Special, Cold-Call, etc....)

What would you like to use for a password? (case sensitive)

(REQUIRED)

NOTE:

	$25.00 minimum net order (before shipping, COD, etc.)
	Shipping charges will be added to all orders.
	All pricing subject to change without notice.
	All exchange item cores are due on our dock within 30 days, otherwise you will be billed the core charge.
	A valid resale certificate must be on file in our office. You can download a Universal Resale Certificate from our eOffice on our web site.