New/Existing Customer – Broadstroke, Inc.

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New/Existing Request Form

For adding or updating Company/Customer and Contacts in Quickbooks and InfoFlo

"*" indicates required fields

Your Email Address*

New or Existing Company / Customer*

New

Existing

How did they hear about us?*

Example: Wiba event, Chamber event, referred by (say who please), etc.

Existing Company/Customer Name*

What needs to be updated?*

Company Information

Add Contact

Edit Contact

Remove Contact

Tax Exempt Status

Other

Please specify what needs to be updated*

Company/Customer Name

Company/Customer Main Email Address

Company/Customer Main Phone #

Company/Customer Physical Address

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

Company/Customer Name*

Company/Customer Main Email Address*

Company/Customer Main Phone #*

Company/Customer Physical Address*

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

Tax Exempted?

Yes

No

Tax Exempt Reason*

File(s)

Drop files here or

Accepted file types: zip, pdf, jpg, png, eps, Max. file size: 12 MB, Max. files: 4.

Sales / CSR

Contact Name

First Last

Contact Email Address

Contact Type

Contact Phone #

Contact Mobile #

Is the Billing Contact info the same as above?

Yes

No

Billing Contact Name*

First Last

Billing Contact Email Address*

Contact Type

Billing Contact Phone #

Billing Contact Mobile #

Billing Address same as Company/Customer Address?

Yes

No

Address

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

Is the Shipping Contact info the same as contact?

Yes

No

Shipping Contact Name*

First Last

Shipping Contact Email Address*

Contact Type

Shipping Contact Phone #

Shipping Contact Mobile #

Shipping Address same as Company/Customer Address?

Yes

No

Address

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

Additional Information

Email

This field is for validation purposes and should be left unchanged.

Δ

820 W 2nd St N, Wichita KS 67203

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