Customer Update Form | Assurance Technologies Inc.

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Customer Update Form

CUSTOMER INFORMATION UPDATE

BUSINESS CONTACT INFORMATION

Business Name*

Business Phone*

Business Fax*

Business Information*

Address

City

State / Province / Region

Zip code

Country

Is your billing address same as your shipping address*

Yes
No

Billing Address

Address

City

State / Province / Region

Zip code

Country

PRIMARY QUALITY CONTACT

NAME*

TITLE*

Phone*

Email*

SECONDARY QUALITY CONTACT*

Title*

Phone*

Email*

Required Certificate Access*

Yes
No

ACCOUNTING CONTACT

NAME*

Phone*

EMAIL*

Are you interested in talking with A/R team about setting up ACH payments to reduce check printing?

Yes
No

PURCHASING CONTACT

NAME

Phone*

EMAIL

PLEASE INCLUDE CERTIFICATE OF RESALE, W9, AND/OR MACHINERY TAX EXEMPTION (IF APPLICABLE)

Upload here

Upload here

Upload here

QUESTIONNAIRE

Does your facility have a preference of shipping through UPS or FedEx*

Account Number*

Do you authorize ATI to use this account ship new gages or calibration back to your facility

Is WIFI available for on site calibration?*

Yes
No

If Yes, How does our team access the guest account*

What are your standard hours that our service team can be on-site for?*

What type of Measurement tools do you use internally?

Hand Tools

Thread Gaging

CMM

Vision Systems

Form Equipment

Hardness Testers

Do you have any interest in advancing your team metrology knowledge with contracted timing?

Hand Gage Usage

Blueprint Reading

2-Day Fundamentals of GD&T

Other

If ATI had a delivery service that a charged flat rate for pick up and drop off your calibration instead of shipping would you be interested in it?

Yes
No

If you have any questions or concerns, please feel free to contact Assurance Technologies, Inc. at 630-550-5000 or sales@atiquality.com

Thank you for taking the time to update your company information. Once you hit the submit button you will get entered into a raffle for 2 free 4-hour training seminars at one of ATI's monthly classes in 2023 or 2024 ($1,400.00 value).

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Contact

Offices
Elgin, IL: (630) 550-5000
Warsaw, IN: (574) 385-2880
Toll free: (800) 231-1782
Sales
Rockford, IL: (630) 550-5000
Milwaukee, WI: (800) 231-1782
Madison, WI: (262) 719-9749
Warsaw, IN: (574) 385-2880

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