Registration

Untitled Document

For full access to our website, please fill in the registration form below. You will receive a confirmation email. Please follow the links in this email to complete the WEBSITE REGISTRATION process.

Your NEW CUSTOMER REGISTRATION will not be approved until all of the following paperwork has been submitted. Please print forms and send them to Mears Floral Products, Inc. via fax, mail or email.

New Customer Form

Tax Form 149

Fax: (417) 831-6962

Mailing Address: P.O. Box 4347 Springfield, MO 65808

Email: Kristina@mearsfloral.com

Registration

Company Name:	*
Username:	*
E-mail:	*
Password:	*
Verify Password:	*

Are you reselling?

ADDRESS

Billing

Contact

Address

City

State

Zip

Country

Phone

Fax

Shipping ( if not same as Billing)

Company

Address

City

State

Zip

Country

Phone

Fax

Memo

DOCUMENTATION You will not be approved until all documentation is submitted

Additional Documents Submitted

Application Form	No Yes
Tax Form 149	No Yes
State License	No Yes

COMPANY INFORMATION

Company Type

Places of Business

Floral Shop	No Yes
Gift Company	No Yes
Other

Store Front	No Yes
Warehouse Facility	No Yes
Work out of Home	No Yes
Web Store	No Yes

Web Address

You will receive a confirmation email once your account is approved

Salesman
Credit Limit
Price List
Farm Direct Markup %(i.e. 40.00)
Show Farms	No Yes
Allow Direct PO	No Yes

Fields marked with an asterisk (*) are required.