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Client Account Information Form

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Client Account Information Form

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To provide you with the highest quality service possible, we are requesting information for your account with us. Thank you in advance for your assistance.
Vivid Image Account Director*
- Cegi Wassman
- Heidi Arndt
- Kori Sanders
- Kristal Ehrke
Are you a new or existing client?*
- New
- Existing

New Client Account Information
Company Name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Website URL/Address*
If we will be working with you to create a brand new website, please enter NONE
Primary Account Contact
Primary Account Contact*
First Name Last Name
Phone
Primary Account Email Address*
Would you like to be added to our email lists for:*
- VI Monthly eNewsletter
- Upcoming Classes
- Marketing and Promotions
- Please do not add me to your email lists
Technical Information
Who should we contact regarding domains, DNS records, Internal Networks, etc.?
Technical Contact*
First Name Last Name
Company
If you have Technical Support through an outside company, please list it here.
Phone
Technical Contact Email Address*
Would you like your Technical Contact added to our email lists for:*
- VI Monthly eNewsletter
- Upcoming Classes
- Marketing and Promotions
- Please do not add them to your email lists
Billing Information
Billing Contact*
First Name Last Name
Phone
Billing Contact Email Address*
Would you like your Billing Contact added to our email lists for:*
- VI Monthly eNewsletter
- Upcoming Classes
- Marketing and Promotions
- Please do not add them to your email lists
Our Credit Policy:
- Our payment options are cash, check, Visa, MasterCard, & Discover.
- Time is billed in 15 minute increments.
- Our payment terms are Net 15.
- If we have not received your payment in our office by its due date, we may apply a late fee of $20.00. The late fee may be reapplied each month your account is overdue.
- If your account becomes overdue by 60 days, we may take down your website and/or emails and put your account on hold. If we have to do this, there will be a $150.00 fee to resume services. When payment has cleared, including the fee to resume services, for all outstanding invoices, we will reinstate your website and/or emails and resume work.
- If your check is returned, there will be a $30.00 charge.

What Social Media accounts do you currently have?
Such as Facebook, LinkedIn, Instrgram, TikTok, etc. Please include the urls.
Do you use an Email Marketing program? If yes, please let us know which one and how long you've used it.
Such as MailChimp, Constant Contact, ActiveCampaign, etc.
Do you use a CRM program? If yes, please let us know which one and how long you've used it.
Such as SalesForce, HubSpot, Insightly, etc.

Account Information Update
Company Name*
What information would you like to update?*
- Company Address &/or Phone
- Main Contact Info
- Technical Contact Info
- Billing Contact Info
- Other Contact Info
* Please check all that apply. Updating only the Main Contact will not update Billing and/or Technical Contacts.
These changes will be used to update your overall account with Vivid Image. Please note that these changes will not carry over to your website, Social Media accounts, or any other Third Party accounts.
Would you like your Account Director to reach out about carrying these updates over to your website?*
- Yes, please.
- No thanks. We will make any needed changes ourselves.
Should all outstanding invoices be emailed to the new Billing Contact?*
- Yes, please resend all open invoices.
- No thank you.
Company Address &/or Phone
Updated Address
Street Address Address Line 2 City State ZIP Code
Phone
Main Contact Info
Updated Main Contact*
First Last
Updated Main Contact Email*
Updated Main Contact Phone
Email Preferences*
- Yes, please add me to your email marketing & newsletter list
- No, do not add me to your email marketing & newsletter list
Technical Information Update
Updated Technical Contact*
First Name Last Name
Updated Technical Contact Email Address*
Updated Technical Contact Phone
Email Preferences*
- Yes, please add our updated Technical Contact to your email marketing & newsletter list
- No, do not add our updated Technical Contact to your email marketing & newsletter list
Billing Information Update
Updated Billing Contact*
First Name Last Name
Updated Billing Contact Email Address*
Updated Billing Contact Phone
Email Preferences*
- Yes, please add our updated Billing Contact to your email marketing & newsletter list
- No, do not add our updated Billing Contact to your email marketing & newsletter list
Other Contact Information
Other Contact*
First Name Last Name
Other Contact Title/Role
Other Contact Email Address*
Other Contact Phone
Email Preferences*
- Yes, please add our Other Contact to your email marketing & newsletter list
- No, do not add our Other Contact to your email marketing & newsletter list
Is there anyone else we should add or remove from your account?*
- Please add someone
- Please remove someone
- No need to add or remove anyone
Please provide details.*
Data Consent*
- I consent to my submitted data being collected and stored
Terms & Conditions*
- By clicking Submit, you are confirming that you have read, understood, and agree to Vivid Image's Client Terms & Conditions

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