New CustomerForm

We're one step closer to having an awesome relationship. Please complete the form below to get entered in our system as a new customer. We can't wait to work with you!
* Indicates required fields

Company

Contact Information

Billing Information

Delivery Address

Which one of our reps have you been working with? *
What services are you most interested in?
(Select all that apply)
Upload Tax Exempt Form
If you are tax exempt, please upload a copy of your tax exempt form here. Please note that Indiana changed regulations at the beginning of 2023. There has been an extra section added to the ST-105. Non-profits can no longer use the ST-105, they must log in to the INtime account and create an NP-1 to purchase tax exempt.
Accepted file types: .jpg, .jpeg, .png or .pdf. Max. file size: 512 MB.
TERMS *
Customers need to put a credit card on file that will be charged upon pickup/delivery or will be sent an invoice to prepay for orders. After your first order you are eligible to apply for terms with our application for credit.

Credit Card Information

Consent *

    • If you choose Yes, by signing below you are authorizing Hightower Graphics, Inc. to deduct from the card noted above for this and future purchases.
    If you choose No, you will be changed to Prepay terms after your first order until you put agree to put a new card on file or fill out our credit application.

    I (we) state that all information forth mentioned is true. I authorize the company Hightower Graphics, Inc. to charge the above credit account for purchases made from Hightower Graphics, Inc. I agree to pay any incurred legal non-refundable fees for each dispute. The undersigned agrees to act as a personal guarantor and cosigner to this agreement for all debts incurred both now and in the future for all monies owed by the Company, Organization, Persons, or Corporations who have signed this credit authorization. Guarantor recognizes, understands and agrees that this guarantee cannot be revoked or rescinded if any balance remains owed and outstanding to the vendor and guarantor herby waives their subrogation or recovery rights.

Signing Applicant

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