GraphicBiz Corp. - Client Information Form

Dear customer, it's very important to have accurate and current information about your business. Please, spare us a few minutes and complete this short form with your data. Double check all your entries for greater accuracy.

For US customers only. Other countries customers please go here

Your name

Company's Position

Company's Position (Other)

Current e-mail address

Telephone

Your Birthday

Fill all fields. Then, continue with Company Information.

	Business Legal Name
	Business President/Principal
	Business Size
	Business Type
	Business Location
	Business Activity
	Main Activity Describe products and/or services sold:
	Business Address 1
	Business Address 2
	City
	State
	ZIP
	Company's Phone Number
	Company's Fax Number
			Fill all fields. Then, continue with Web Information.

	Does your company have a web site?
			If yes, please fill appropriate fields. If not, please fill desired names.
	Business URL
	Web Store Name (i.e. My Biz Online or such)
	Other Domains


			FTP Access (Needed only if access to your server for uploading and site maintenance is required by you.)
	Host Server Machine		Other:
	ftp address
	IP Address
	ftp login
	ftp password
	re-enter ftp password

	Add comments pertinent to your business, web strategy, aimed market, etc.
			Be sure all areas above are completed before submiting your profile to our secured database.

GraphicBiz Corp. never release customer information to third parties unless otherwise indicated by the customer by written agreement. More about GraphicBiz Corp. policies.