Border Texture
BUSINESS ADDRESS
SALES CONSULTANTS WHERE APPLICABLE *
PRIMARY OPTICAL CONTACT #1
PRIMARY OPTICAL CONTACT #2
BILLING CONTACT NAME
IS YOUR BILLING ADDRESS DIFFERENT THAN YOUR BUSINESS ADDRESS?
BILLING ADDRESS
PREFERRED PAYMENT METHOD *

Self-Managed Web Payments are online payments via SpecCheck. Auto Payments are payments through COL via CC/ACH

ORDER/JOB TYPE
ARE YOU A PROVIDER FOR ANY OF THE FOLLOWING? IF YES, SELECT ALL THAT APPLY.
WHICH SOFTWARE ARE YOU CURRENTLY USING TO ORDER ONLINE?
ARE YOU CURRENTLY UTILIZING THE COL HAPPY HUMAN TOOLS?
IF YOU’RE INTERESTED IN LEARNING MORE ABOUT OUR HAPPY HUMAN TOOLS, SCHEDULE A MEETING WITH OUR KICKOFF TEAM TODAY! www.calendly.com/kickoffteam
ARE YOU INTERESTED IN RECEIVING INFORMATION ON ELECTRONIC ORDERING? *
RANK YOUR PREFERRED COMMUNICATION WITH ONE BEING MOST PREFERRED METHOD AND FIVE BEING LEAST PREFERRED METHOD (Ex: Slack, SpecCheck, Email, Phone, Fax, etc.)