New Customer Registration Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Company Named/b/aContact (Principal / Owner) *FirstLastContact Cell PhoneContact Email *Company Address that Volume or CityStateZipCompany PhoneCompany FaxCompany EmailBusiness Category (check one)C CorpS CorpLLCSole ProprietorshipOtherBusiness Category (if Other, describe below) Business Type (check one or more that apply)Display DistributorJewelry Supply DistributorStationery Products DistributorOther Product WholesalerRetailerIndividualOtherBusiness Type (if Other, describe below)Products Sold:Your Typical CustomerAutostat Products of InterestEstimated Volume per annum of tags, labels or any combination of Autostat products shown: $Selling Region(s) US contiguous StateHawaii, Alaska and Puerto RicoExport Countries SoldCanadaMexicoOtherExport Countries Sold (if Other, describe below)Submit
