First Name:

Last Name:

Company Name:

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Address 1:

Address 2:

City:

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Zip/Postal Code:

Phone #:

Ext:

Fax:

Business Type: Please Select Retailer Supplier Professional Manufacturer Wholesale Distribution Other

Preferred Contact Method: Please Select Any Email Phone Fax Mail

Best Time To Contact: Please Select Morning Afternoon Evening

Other Shipping Contacts:

Email Address:

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Do You Currently Ship with FedEx?: Please Select Yes No

If Yes, Please List Your Account #:

If you do not have a FedEx account number, one will be assigned to you.
You should be aware that FedEx requires a credit card with most new accounts and that they will be calling you directly within the next few days to obtain your credit card information.

Send (outbound): Please Select 0 1-10 11-25 26-50 51-100 101-250 251 or more Not Sure

# of Ground small package shipments per month:
Typically B2B or B2C parcel shipments <150 lbs.

Send (outbound): Please Select 0 1-10 11-25 26-50 51-100 101-250 251 or more Not Sure

Received (inbound): Please Select 0 1-10 11-25 26-50 51-100 101-250 251 or more Not Sure

# of LTL (less-than-truckload) freight shipments per month:
LTL shipments are typically >150 lbs. and/or palletized.

Sent (outbound): Please Select 0 1-10 11-25 26-50 51-100 101-250 251 or more Not Sure

Received (inbound): Please Select 0 1-10 11-25 26-50 51-100 101-250 251 or more Not Sure

# of Truckload (TL) freight shipments per month:
TL shipments are typically >10,000 lbs. and/or require a flatbed or refrigerated truck.

Sent (outbound): Please Select 0 1-10 11-25 26-50 51-100 101-250 251 or more Not Sure

Received (inbound): Please Select 0 1-10 11-25 26-50 51-100 101-250 251 or more Not Sure

# of Tradeshow or exhibit freight shipments per month:

Exhibit Shipments: Please Select 0 1-10 11-25 26-50 51-100 101-250 251 or more Not Sure

Exhibit Shipments:

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