Set Up a Net 30 Day Account

[Image of woman smiling.] Many of our larger business customers prefer to be billed for purchases and pay with thirty day terms. Simply fill out our web form and we will call you with your Account Number and confirm your billing and shipping information. Accounts are often set up the same day but occasionally take longer.

*Required entries are marked with an asterisk.

*Contact Name:
Title:
*Company:

Billing Information

*Address Line 1:

Address Line 2:

*City:

*State:

Country:

*Zip:

*Phone:

Ext:

Fax:

*E-mail:

Shipping Information

Same as billing

Contact:

Address Line 1:

Address Line 2:

City:

State:

ZIP:

Phone:

Ext:

Fax:

Account Requirements

Do you use Purchase Orders on every order?

Yes

Do you use Cost Center or Departmental billing?

Yes

*Number of employees for whom you purchase supplies:

Estimated monthly spending on office products:

Online Ordering

Select a User ID: (6-12 characters)

Please contact me regarding User ID's for additional Online Buyers:

Yes

I am interested in the following GSB product lines:
(Check all that apply)

Promotional Code

If you have a Promotional Code, enter it here:

How did you hear about us?
(Check all that apply)

If you were contacted by a salesperson and know their name, please enter it here:

Payment Preferences

	Pay by credit card Give Something Back accepts Visa, JCB, MasterCard, Discover, and American Express.
	Pay by Electronic Funds Transfer (EFT) Account Name: Give Something Back Inc. Bank Name: Citibank West FSB Bank Routing Number: 321171184 Account Number: 201773652 Email Contact: eft@givesomethingback.com
	Bill Me — Net 30

General Terms and Conditions

Bills are sent after each order. All bills are due according to the agreed upon terms. No additional credit will be extended to past due accounts unless satisfactory arrangements are made with our Accounts Receivable department.

I hereby authorize release of any credit information from any source, to Give Something Back Inc. for the purpose of extending credit. The above information is submitted for the purpose of opening an account, and I do hereby certify that this information is true and correct.

I have read and agree to the above terms and conditions

NewCustomer

	Office Supplies
	Paper
	Toner
	Printing
	Office Furniture
	Computer Supplies
	Janitorial Products
	Advertising Specialties

	Radio advertisement
	KYLD Wild 94.9 KISQ Kiss 98.1 KGBY My92.5 KIOI Star 101 KHYL V101.1 Green 960 AM
	Contacted by salesperson
	Received something in the mail
	Saw delivery truck
	This web site
	Media article
	Referral
	Other

Set Up a Net 30 Day Account

NewCustomer

MyLinks

New MyGSB Site

Set Up a Net 30 Day Account

NewCustomer

MyLinks

OnlineOrdering

New MyGSB Site