Welcome Packet Client Information Request

TrashBolt New Client Information Request Form

Welcome TrashBolt Clients! Please provide as much information as possible to help us begin your TrashBolt System Setup.

Welcome Packet Form

Name of Person Completing Form*

Email*

Company Name*

Credit Card Processor Option Selected*

Invoice Option*

Billing Contact Name

Billing Email

Billing Street Address

Billing Street Address 2

Billing City

Billing State

Billing Zip

Logo Use Permission – Can we use your company logo*

Upload Your Logo File (Optional)

File(s) size limit is 20MB.

Mapping Contact Name*

Mapping Contact Email*

Mapping Contact Phone

Online Agreement Forms Contact Name*

Form Contact Email*

Form Contact Phone

Deployment Contact Name*

Deployment Email*

Deployment Phone

Website Admin Name

Website Admin Email

Name of Website Admin Company if an Outside Agency

Website CMS Used

Billing Contact 2 (Opt)

Billing Email 2 (Opt)

Billing Phone 2 (Opt)