COL Account Updates

BUSINESS OWNER NAME *

COL ACCOUNT NUMBER *

BUSINESS NAME *

BUSINESS ADDRESS

STREET *

CITY *

ZIP CODE *

STATE *

BUSINESS PHONE *

BILLING CONTACT EMAIL *

PRIMARY OPTICAL CONTACT #1 *

PRIMARY OPTICAL CONTACT #1 PHONE *

PRIMARY OPTICAL CONTACT #1 FAX

PRIMARY OPTICAL CONTACT #1 EMAIL *

PRIMARY OPTICAL CONTACT #2

PRIMARY OPTICAL CONTACT #2 PHONE

PRIMARY OPTICAL CONTACT #2 FAX

PRIMARY OPTICAL CONTACT #2 EMAIL

BILLING CONTACT NAME *

BILLING CONTACT PHONE *

IS YOUR BILLING ADDRESS DIFFERENT THAN YOUR BUSINESS ADDRESS?

Yes

BILLING ADDRESS

STREET *

CITY *

ZIP CODE *

STATE *

PREFERRED PAYMENT METHOD *

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

Self-Managed Web Payment

Auto Payment

ORDER/JOB TYPE

Edged

Uncut

Both

ARE YOU A PROVIDER FOR ANY OF THE FOLLOWING? IF YES, SELECT ALL THAT APPLY.

Avulux

SHAW

WHICH SOFTWARE ARE YOU CURRENTLY USING TO ORDER ONLINE?

SpecCheck

DVI/RX Wizard

Vision Web

Not Ordering Online

ARE YOU CURRENTLY UTILIZING THE COL HAPPY HUMAN TOOLS?

Yes

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? *

Yes

PREFERRED EMAIL FOR E-STATEMENTS? *

PREFERRED EMAIL OR FAX TO RECEIVE DAILY WIP REPORT OR DELAY NOTICES *

PREFERRED EMAIL TO RECEIVE POLICY/PRICING MEMORANDUMS *

PREFERRED EMAIL TO RECEIVE PROMOTIONAL, GIVEAWAY, EVENT INFO

RANK YOUR PREFERRED COMMUNICATION WITH ONE BEING MOST PREFERRED METHOD AND FIVE BEING LEAST PREFERRED METHOD (Ex: Slack, SpecCheck, Email, Phone, Fax, etc.)

1. *

2. *