New Account Form – CCI Learning

New Account Form

    New Account Form

    Billing Address
    Billing Address
    Shipping Address (if different than Billing)
    Shipping Address
    (if different than Billing)
    Accounting and Payment Information


    AGREEMENT FOR CREDIT SALES: The above information is for the purpose of obtaining credit and is warranted to be true. I hereby agree to pay all invoices within 30 days of receipt of invoice or as expressly agreed. Interest of 2% may be charged on overdue invoices. I hereby authorize CCI Learning Solutions Inc. to obtain such credit reports or other information as may be deemed necessary in connection with the establishment and maintenance of a credit account.I agree to agreement written above Authorized Applicant: Title: Date: