Account Form | Unlimit IT Solutions

Business Name*

Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Fax

General Email

GST/HST Number

Point of Contact

This is the person we will contact with respect to the services we provide

Name*

First Last

Phone*

Email*

Please give this person access to the customer portal

Yes

Payment Information

My company requires the use of purchase orders*

Yes
No

Credit Terms Requested*

Accounts Payable Contact Person

This is the person we will contact with respect to invoices or payment information

Is the Accounts Payable Contact the same as the Point of Contact above*

Yes, the billing contact is the same as Point of Contact above
No, Invoices should go somewhere else

Name

First Last

Phone

Email

Please give this person access to the customer portal

Yes

Authorization*

I, as an authorized signer for the above stated business, certify that this information is correct to the best of my knowledge. I hereby authorize Unlimit IT Solutions Corp. to store and use the above information to facilitate the delivery of web services.

Yes I am authorized to accept these terms and I Agree to them

Terms and Conditions

Point of Contact

Payment Information

Accounts Payable Contact Person