Customer Information Form

After you have read our Policies and Agreements and have decided to become a customer of OLSON STUDIOS, please fill out the following and submit this Form via our secure link to the OLSON STUDIOS Billing Department using the button at the bottom.

NOTE: If you are uncomfortable giving us this information over our secure link, you may call us and provide your information over the telephone.

OLSON STUDIOS cannot respond to your submission unless you provide us with your real name and a valid e-mail address.

All listings followed with an asterisk (*) must be filled out. Failure to do so may result in having to resubmit this Form. Please enter your information in the spaces provided below before submitting the Form to us.

Your Full Legal Name*:

[Customer Information]

Company Name:
Title (Mr./Ms./Dr./etc.):
First Name*:
Middle Initial/Name:
Last Name*:
Contact*:
Phone*:
FAX:
Alternate Phone:
Alternate Contact:
E-mail*:	(e.g.: you@yourISP.com)

[Addresses]

[Bill To]

Name*:
Address*:
Address Line 2:
City*:
State or Province*:
Zip or Postal Code*:
Country*:

[Ship To]
(If shipping address is left blank it will be considered ''same as billing address''.)

Name:
Address:
Address Line 2:
City:
State or Province:
Zip or Postal Code:
Country:

[EIN and/or SSN]

Company Tax Identification Number
and/or
Customer Social Security Number*:

(Note: If you do NOT have an EIN you MUST provide your Personal SSN.)

[Verification Password]

The Password you select may be requested by OS periodically to verify authenticity of requests for Service placed by Customer.

Password you would like to start with*:

Type your password in again please*:

By clicking the button to the left I indicate to those whom it may concern that I have read, I understand, and I agree to all terms, conditions, and provisions covered under the OLSON STUDIOS' Policies and Agreements found on this OLSON STUDIOS' website*

Handwritten signature is not necessary when using this on line Form.

Your submission of this Form will be deemed your handwritten signature.

Click the submit button below to send your information over our secure link.