Harold Import Company, Inc. 747 Vassar Avenue Lakewood, NJ 08701 800-526-2163 PH 732-364-3253 FAX info@haroldskitchen.com
NEW CUSTOMER INFORMATION FORM
In order to expedite the creation of your HIC account, please provide us with as much information as possible. Fields with a red asterisk are required. We cannot set up your account without these fields filled in. If you have any questions, please call us at 800-526-2163. Any customer service representative will be happy to help you.
If you have any difficulty submitting this form or if you prefer to print and send a hard copy, click here for a printable version. Thank you.
Business Name*
Mailing Address* Zip*
Shipping Address Zip
Phone (Business)* Phone (Cell) Fax
E-mail Address* Website Address
Business Owner - Name* Buyer - Name
Type of Business (briefly describe) Wholesale Retail How did you hear about Harold Import Company? (Ex. HIC Sales Rep, Customer Recommendation/Word of Mouth, Tradeshow/Trade Event, Industry Ads/Press, Web Search, etc.) Please indicate in box below.
Please send me the current HIC catalog and pricelist.
Please sign me up for the Hic E-News (The HIC E-News is distributed about 10 times per year - to see archived editions, go to the "What's New" section of our website. IF SIGNING UP FOR THE HIC E-NEWS, PLEASE MAKE SURE THAT WE HAVE YOUR E-MAIL ADDRESS.)
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PAYMENT INFORMATION*
Accounts Payable Contact - Name Phone
RESALE TAX ID#*
Method of Payment (Please Select One)*
COD (with certified check or money order only) Check payment in advance Other (If choosing this option, please send us your credit sheet - see contact information at the top of the form.) Credit Card (if choosing this option, please fill out appropriate information below)
Credit Card Type: VISA Mastercard American Express Discover Credit Card # Exp. Date (Month, Day, Year)
Credit Card Billing Address Zip
Do you have any special information or instructions that you would like us to note in your account? (Ex. Shipping instructions, backorder procedures, alternative contact information, etc.) If yes, please describe in the box below. Thank you.
Once we have received and verified your information, we will contact you with a HIC account number and an online password for wholesale ordering. Under normal circumstances, you can expect to be contacted within two business days.
Thank you again.