New client setup- Brook + Whittle

Get setup as a new client

Please complete the form below.

New Client Setup

"*" indicates required fields

Contact information

First name*

Last name*

Job title*

Email*

Phone*

Are you already working with Sales or another Brook + Whittle representative?*

Yes

Sales Rep or Brook + Whittle employee name

Billing information

Employer Identification Number / Federal Tax ID #*

Sales Tax exempt?*

Yes

Sales Tax Exempt #

Or, who can we contact for this number?*

Please provide the email address for this contact.

Please upload your Sales Tax Exemption form

Max. file size: 300 MB.

Or, who can we contact for this form?

Please provide the email address for this contact.

First order value

Please enter a $ amount for your first order

Are you the AP contact?*

Yes

AP contact full name

AP contact email

AP contact phone

Is the billing address the same as the business address?*

Yes

Billing address

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

Will you be applying for terms?*

Yes

How will you apply?*

I have a trade reference sheet to upload

I need to fill out the terms application

Upload a trade reference sheet*

Max. file size: 300 MB.

Terms application

Reference 1: Company*

Company name

Reference 1: Company address*

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

Reference 1: Contact email address*

Please provide an email address for your contact at this company.

Reference 1: Contact phone

Please provide a phone number for your contact at this company.

Reference 2: Company*

Company name

Reference 2: Company address*

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

Reference 2: Contact email address*

Please provide an email address for your contact at this company.

Reference 2: Contact phone

Please provide a phone number for your contact at this company.

Reference 3: Company*

Company name

Reference 3: Company address*

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

Reference 3: Contact email address*

Please provide an email address for your contact at this company.

Reference 3: Contact phone

Please provide a phone number for your contact at this company.

Information release*

By clicking here, I authorize the release of information from the above references to Brook + Whittle.

Payment terms

By clicking here, I agree to payment terms of 30 days, unless otherwise agreed.

If left unchecked, a team member will be in contact.

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Legal

Terms + conditions of sale*

By clicking here, I agree to the terms and conditions of sale.

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Marketing

What products are you interested in?*

Select all that apply

What markets does your business serve?

Select all that apply

Name

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

Stay in the know with Brook + Whittle

Headquarters – Guilford

20 Carter Drive
Guilford, CT 06437

(203) 483-5602

New client setup

Get setup as a new client

New Client Setup

Contact information

Company information

Billing information

Terms application

Legal

Marketing

Stay in the know with Brook + Whittle

Headquarters – Guilford

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