Form

Company Name*

First Name*

Last Name*

E-mail*

Billing Address*

City*

State*

Zip Code*

Shipping Address

Shipping Address (2)

City

State

Zip Code

Phone #*

Extension #

Account #

Dept # (if known)

Here are just a few more questions to assist us in setting your account and user up accurately. With the vast number of features and benefits available for BSonline2, we want to make sure we have given your company as many options as possible.

Nearest Location

Sioux Falls, SD Bismarck, ND Fargo, ND Minot, ND

I am a current user

Yes, but on the old ordering system No, I have not used your online ordering before

Credit Card Options

Yes, Credit Cards MUST be used to purchase Yes, Credit Cards allowed, may bill to account also No, we do not allow Credit Card purchases

We use HP Purchase Edge, enter your HP# number for Purchase Edge

If Account has Departments, user allowed to order for all departments?

Yes, we have depts, and I am able to order from all Yes, but I can ONLY order from dept above No, we do not have departments

Do you order for more than one account #?

Yes No

Allow Statement display and payment remittance online

Yes, we would like to view/print our statement & remit account online if desired No, we are not interested

Do you need to have your purchases approved by another party prior to submitting?

Yes, I need approval No, I do not need approval for purchases

If you need approval, please enter the email address of approver

Now that I'm signed up as a user, I'd like someone to contact me about the following

Favorite Listings Machine Matching Order Approval Process Online Training to learn all the features & benefits Payment/Viewing Invoices Order History expenses

Other information that may assist us in setting up your account