[86 Repairs] Vendor Intake Form

Vendor Intake Form

We're excited to have you join our network of trusted vendors! This form will take 5 minutes (or less!) to complete.
Basic Information

This is just the easy stuff! If you have separate Billing and Dispatch emails, you will be prompted to provide them in the next section.
Company Name*
Email*
This must be the EXACT email to which this form was sent! If your primary email differs from this one, please provide it in the next question.
If your business's primary email is different from the above, please provide:
Website
(Only if you have one!)
Dispatch Email
example@example.com
Dispatch Phone Number
Please enter a valid phone number.
What is your preferred method for dispatch and follow-up?*
Address*

Street Address

Street Address Line 2

CityState

Zip Code

Vendor Intake Form