NEW CLIENT REGISTRATION FORM

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Business Name*
Name*
First Last
Business Address*
City*
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Postal Code / Zip*
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Billing Information
Cardholder's Name*
As it appears on the Credit Card
Credit Card #*
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Is the Billing Address the same as address you entered above?*
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Billing Address*
City*
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Postal Code / Zip*
Country*
CREDIT CARD AGREEMENT: I UNDERSTAND AND AGREE THAT MY AUTHORIZATION ON THIS CONTRACT WILL SERVE AS MY AUTHORIZED SIGNATURE ON THE CREDIT CARD SLIP FOR ALL ORDERS PLACED THROUGH CHRONOS MARKETING USING THE ABOVE CREDIT CARD NUMBER. IN THE EVENT THAT THE BILLING INFORMATION CHANGES, THE CLIENT MUST FILL OUT A NEW AUTHORIZATION FORM. THE CLIENT IS RESPONSIBLE FOR NOTIFYING CHRONOS MARKETING OF ANY ACCOUNT CHANGES. IN THE EVENT OF AN ACT OF GOD, ELECTRICAL FAILURES, AIRLINE OR SHIPPING COMPANY DELAYS, CANCELLATIONS OR PACKAGE MISHANDLING, ETC. IMPAIR THE DELIVERY, CHRONOS MARKETING WILL NOT BE HELD RESPONSIBLE. CHRONOS MARKETING WILL MAKE EVERY ATTEMPT TO COMPLETE AND SHIP THE CUSTOMER’S JOB ON SCHEDULE. THE CUSTOMER AGREES NOT TO HOLD CHRONOS MARKETING LIABLE UNDER ANY OF THE ABOVE CONDITIONS. Terms & Conditions | Privacy Policy
Acknowledge Terms and Conditions*
I acknowledge that I read and accept the above agreement as well as the terms and conditions as indicated by Chronos Marketing on their Terms & Conditions | Privacy Policy above.
Authorization Name*
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Account Profile