To: Director of Pricing As a member in good standing with the Document Management Industries Association, please accept this request to enroll my company in the negotiated pricing program of fifty percent (50%) on minimum charge shipments and fifty-five percent (55%) on LTL outbound prepaid and inbound collect shipments. I understand you will send my company confirmation as to the application of the program and the effective data of that program as quickly as possible. Contact Name: ______________________________________________________________Contact Title:________________________________________________________________ Company Name: _____________________________________________________________ Address: ___________________________________________________________________ City:___________________________ State:_______ Zip:__________-_______ Phone/Fax: ______-________-_________ FAX:_______-_________-________ Signature: ___________________________________________ |