New Customer Information

Welcome! Start here to get set up as a new customer, arrange credit terms, and more. We offer one, simple to complete, online form that can get you set up with the multiple suppliers that Pink Pony represents. Each individual supplier will establish terms and invoice separately.
Please complete all sections to the best ability. Make sure to “Send” at the bottom. Only forms submitted online can be processed.

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Company Legal Name

DBA (if used)

Company Type | Sole proprietorship / Partnership / Corporation / Other (please specify)

Tax ID Number / State Resale Number

Date business commenced (YYYY-MM-DD)

Primary Contact Name

Primary Contact Email

Primary Contact Title

Primary Contact Phone Number

Accounts Payable Contact Name

Accounts Payable Email

Accounts Payable Phone Number

Registered Company Address| City, State/Province, Postal Code, Country

Bank Name

Bank Contact Name

Bank Contact Email

Bank Contact Phone

Bank Account Number | Checking

Bank Account Number | Savings

Trade Reference 1 Company Name

Trade Reference 1 Address | City, State/Province, Postal Code, Country

Trade Reference 1 Phone

Trade Reference 1 Email

Trade Reference 2 Company Name

Trade Reference 2 Address | City, State/Province, Postal Code, Country

Trade Reference 2 Phone

Trade Reference 2 Email

Trade Reference 3 Company Name

Trade Reference 3 Address | City, State/Province, Postal Code, Country

Trade Reference 3 Phone

Trade Reference 3 Email

Ship To Address | City, State/Province, Postal Code, Country

Routing Instructions

Preferred Freight Carrier

Bill To To Address | City, State/Province, Postal Code, Country

How did you hear about us?

Other Details

New Customer and Credit Request
Customer setup and credit request is made for the following vendors:

Billco International
Habana Brisa
Lilly Rocket
Pink Pony Industries
RNS Designs
Rockin

All invoices are to be paid per terms, subject to approval by each individual supplier listed above. Each supplier, in their own discretion, will determine credit limit and terms with customer. Invoices are to be paid to each supplier as appropriate. Claims arising from invoices or shipments must be made within seven (7) business days. By submitting this application, I authorize the above listed companies to make inquiries into the banking and trade references supplied.

Contact Digital Signature and Date

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