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NEW USER PROFILE
Complete this form to create a new user profile for fast, secure online purchasing.

Fields marked with * are required.

Forgot Password?
 
User Information:
Login Name *
Password *
Confirm Password *
 
First Name *
Last Name *
Company *
Email Address *
Phone *
Address *
Address2
City *
State/Province *
Postal/Zip Code *
Country *
Fax
How did you hear about us? *
Enrolled Member of Tribe
Identification Number

Thank you for your interest in opening a Corporate Account with Players Club Rewards™. A Corporate Account will allow you to make On Account purchases with Players Club Rewards™. Please complete the following form and allow Players Club Rewards™ two business days to respond. In the meantime, purchases may be made using your credit card.

Corporate Accounts are currently available only for companies based in the USA & Canada.
 
Business Information:
Company *
DBA Name (if applicable)
Nature of Business *
 
Type of Business Sole Proprietorship
Corporation
Partnership
LLC
Other:
*
 
Number of Employees *
Years in Business *
Federal ID# *
DUNS# *
 
Billing Address: Same as above?
Address *
Address2
City *
State/Province
*
Postal/Zip Code *
Country *
Note:  Selecting 'United States' or 'Canada' will
force you to choose your state/province
from a list.
 
Accounting Information:
Accounting Contact *
Phone *
Fax
Email *
 
Bank Name *
Account # *
Bank Phone *
Bank Contact *
 
Trade Reference #1:
Company *
City *
State/Province
Contact Name *
Contact Phone *
Contact Email *
 
Trade Reference #2:
Company *
City *
State/Province
Contact Name *
Contact Phone *
Contact Email *
 
Corporate Account Terms:
  1. Applicant certifies that the information provided is correct.
  2. Applicant certifies that all uses of purchased materials will be done in accordance with the End User License Agreements posted on the Players Club Rewards™ web site.
  3. Terms of Credit: 30 days within receipt of Invoice from Players Club Rewards™.
  4. Players Club Rewards™ is authorized to obtain credit information from any bank or trade references provided above.
  5. Default in payment will result in Players Club Rewards™ retaining counsel to institute collections and legal action and Players Club Rewards™ is hereby authorized to recover all costs, including court/arbitration/collection costs and fees, including reasonable attorney's fees plus interest incurred by Players Club Rewards™ in the enforcement of this agreement.
I agree to be bound by the above terms & conditions regarding Players Club Rewards™ Corporate Accounts. I am authorized on behalf of the applicant to enter into such an agreement.
 
Name of Applicant *
Title of Applicant *
Date of Application *

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