Corporate Account Form – Elephants Delicatessen

Principles

Name*

Title*

Name

Title

Business Type*

Is your company a registered non-profit?*

Yes
No

Nonprofit ID Number:

Description of Business or Service*

Requested Credit Amount ($)*

Are purchase orders required?*

Yes
No

Please list any special billing or purchase information we should be aware of:

Authorized Individuals

By submitting this form, you signify that you are authorizing ANY employee of your company who presents themselves to us to make purchases on a House Account that Elephants Delicatessen provides to you, UNLESS you specifically restrict such purchases to the following named individual(s).

Name

Title

Name

Title

Name

Title

Approved Locations*

Catering
Sack Lunch
Online
In-Store

If an order is placed through a retail location, your receipt is your invoice.

Trade References

Business Name*

Email*

Address*

Street Address Address Line 2 City State ZIP Code

Telephone*

Fax

Business Name*

Email*

Address*

Street Address Address Line 2 City State ZIP Code

Telephone*

Fax

Business Name*

Email*

Address*

Street Address Address Line 2 City State ZIP Code

Telephone*

Fax

Open an Account

Company Information

Principles

Authorized Individuals

Trade References

Rewards

Ele-Mail