NEW CUSTOMER REQUEST FORM

Geographic region business will take place: *

Service: *

Air CFS
Ocean CFS
Contract Logistics
Customized Transportation

Request Information:

Requested By First Name: *

Requested By Last Name: *

Company Name: *

Sales Rep's Name:

Referred By:

Requested By Email: *

Requested By Phone Number: *

We (I) agree to pay charges according to current rate. We (I) agree that all unpaid amounts over 30 days are subject to 2.5% finance charge. We (I) authorize the bank, credit, and bond references to release information to STG Logistics Inc. We (I) agree to hold these persons harmless from any claim resulting there from.

Credit Line Requested (Subject to STG Approval) *

Estimated Monthly Volume *

Print Name:*

Title:*

Date:*