HP Business 2 Business Registration Form

Customer Contact Name:               

Title:                                           

Department:                           

Email Address:                              

Password they would like to use:     

Telephone Number:                       

Fax Number:                                 

Company Name:                           

Address:                                      

Address:                                      

City:                                            

State:                                          

Zip Code:                                     

Order Confirmation Email Address:  

Type of Business:                          

Yearly Revenues:                          

Number of Employees:                   

Number of Locations in the US:       

Network O/S:                                

Annual IT Budget:                         

Number Of Desktops:                    

Number Of Laptops:                      

Number Of Servers:                       

Primary Desktop Manufacturer:       

Primary Laptop Manufacturer:         

Primary Server Manufacturer:          

Primary O/S:                                

 Usually purchase equipment by: (ie: retail, reseller, online, catalog)

Is your company Tax Exempt?        NO YES

(If so, please include a signed copy of your tax-exempt certificate)*required*

(If your company has a 501C3 form on file, be sure to include a copy of the form with this registration)

Completed form will be sent to your HP Account Manager:  Earl Chambers

Reseller's Company Name or Dealer ID#:

Reseller Rep's Contact Name:

Reseller Rep's Email Address:

Reseller Rep's Tele#:

Reseller Address: