Select POS Client Registration

Please complete the Client Registration information below, so we may set up an account on your behalf and assist you more efficiently. Thank you!

BUSINESS CONTACT INFORMATION

Name:
Title:

Company Name :

Phone No.*:		Fax No.:

Registered Bus. Address:

City:		State:		Zip:

Years in Business:			Business Type:	Sole Proprietor Partnership Corporation Other

BUSINESS AND CREDIT INFORMATION

Primary Bus.
Address:

No. Years at Address

City:		State:		Zip:

Phone No.*:		Fax No.:

Email Address:

Bank Name :

Contact Name :

Phone No.*:		Fax No.:

Bank Address:

City:		State:		Zip:

BUSINESS/TRADE REFERENCES

REFERENCE #1
Company Name :

Contact Name :

Address:

City:		State:		Zip:

Phone No.*:		Fax No.:

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REFERENCE #2
Company Name :

Contact Name :

Address:

City:		State:		Zip:

Phone No.*:		Fax No.:

Comments:

~PLEASE NOTE~

1. All invoices are to be paid 30 days from the date of the invoice.

2. Claims arising from invoices must be made within seven working days.

3. By submitting this Registration form, you authorize Select POS to make inquires into the banking and business/trade references that you have supplied.



"Our goals are simple and very straight forward. We are here to satisfy your needs now and into the future.

Our services include:

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