Account Manager Details
Employee ID Number:
Sales Rep Commission Rate
New Client Information:
Client's Legal Name (Please verify with client their legal name which is required for their contract and invoice)
Client Start Date:
Does the client go by another name?
What other name does the client go by?
Is there a secondary contact that needs to be added? (The primary contact should already be in SalesForce and EAPX)
Secondary Contact's Name:
Secondary Contact's Title:
Secondary Contact's Phone Number:
Secondary Contact's Email Address:
Is secondary contact's address the same as in EAPX?
What is the Secondary Contact Address?
Materials For Client:
What Vertical is this Client under:
Should materials be shipped to the address that is listed in EAPX?
What Address should materials be shipped to?
Ship Materials to Attention:
Number of EE's:
Are there any special instructions for sending materials?
Is there a Broker for this client?
Name of Brokerage Firm:
Agent Phone Number:
Signor Name (if applicable)
Signor's Email Address
Broker Commission Structure:
Billing & Contract Instructions
Is the client's billing contact or address different than the primary?
Billing Contact's Name
Billing Contact's Title
Billing Contact's Phone Number
Client's Billing Address
Send Invoice to:
Special Billing Instructions:
Document Upload and Intro Email
Upload Census, Health and Other Documents/Files Here:
Max. file size: 50 MB.
Drop files here or
Date to send Intro Email:
MM slash DD slash YYYY