KidEssence Prospective Client Application
Incomplete/blank applications may result in delayed processing. All prospective account applicants must provide a valid resale license/EIN/tax ID from your state of business. Orders will not be accepted without a complete and approved application.
Email address *
Date
MM
/
DD
/
YYYY
Company Name
Your answer
DBA
Your answer
Billing Address
Your answer
Phone
Your answer
Business Structure
Valid Tax ID/EIN/resale license #
Your answer
Owner's Name, Email and Phone
Your answer
Buyer's Name, Email and Phone
Your answer
Payables Contacts (Name, Email and Phone)
Your answer
Shipping Address (if different from billing)
Your answer
Payment Terms
Payment for all purchase orders are due at the time your order is placed. Payment is accepted via credit card, or paypal.
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