Set Up Form

Preferred Multi-Location Set Up:

Bill Locations Separately (Each location receives its own statement.)

Parent/Child Accounts (Main location receives one statement for all locations.)

One Location Only

COMPANY INFORMATION REQUIRED

If there are multiple locations, please provide each location's information in the "Next Location" field.

Invoicing Method

By Mail (Results in all individual invoices mailed as each order is complete.)

Electronically (Results in invoices and statements emailed at end of month only.)

Outside Portal (Results in invoices and statements submitted to your company's chosen portal.)

Purchase Order

Yes - If yes, please indicate "Annual Blanket" or "Per Order PO" in "Other" field below.

Other...

Tax Exempt

Yes - If yes, please email the Tax Exemption Certification to MplsSafety@walmanoptical.com.

Multiple Location Information

Please provide the details for your other locations; if you need assistance, please contact your Safety Support Team: MplsSafety@walmanoptical.com or 844.401.7702.

COMPANY ACCOUNTS PAYABLE INFORMATION REQUIRED

If invoices should be sent to multiple locations, list the AP contact information for each location in the "Next AP Location" field.

Multiple Location AP Contact Information

Please provide the AP details for your other locations; if you need assistance, please contact your Safety Support Team: MplsSafety@walmanoptical.com or 844.401.7702.

PLEASE EMAIL THE FOLLOWING TO MplsSafety@walmanoptical.com:

- your company's invoicing and/or PO requirements

- any special invoicing instructions

- your company's Tax Exemption Certificate (if applicable)

Your Email for Form Confirmation

WELCOME & THANK YOU!

COMPANY INFORMATION REQUIRED

COMPANY ACCOUNTS PAYABLE INFORMATION REQUIRED

PLEASE EMAIL THE FOLLOWING TO MplsSafety@walmanoptical.com:

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