CUSTOMER INFORMATION UPDATES

Company Name*

Company Phone Number

Your Foxworth-Galbraith Location*
---Phoenix, AZPrescott, AZYuma, AZColorado Springs, CODenver, COWoodland Park, COAlamogordo, NMDeming, NMRoswell, NMRuidoso, NMSilver City, NMTruth or Consequences, NMNorman, OKOklahoma City, OKAnthony, TXBelton, TXKilleen, TXDallas/Fort Worth, TXEl Paso, TXLas Cruces, NMKerrville, TXMarble Falls, TXWaco, TXWhitesboro, TXWinnsboro, TX

Account Number

COMPANY ADDRESSES

Physical Address

City

State
---ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY

Zip

Mailing Address (if different from above)

City

State
---ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY

Zip

ADMINISTRATIVE CONTACT (i.e. invoicing, statements, etc.)

Name

Position

Email Address

Direct/Cell Number

Please provide contact information for key personnel that engage with Foxworth-Galbraith (i.e. Owner, Purchasing Manager, Bookkeeper, Superintendent, etc.)

CONTACT #2

Name

Position

Email Address

Direct/Cell Number

CONTACT #3

Name

Position

Email Address

Direct/Cell Number

CONTACT #4

Name

Position

Email Address

Direct/Cell Number

CONTACT #5

Name

Position

Email Address

Direct/Cell Number

CONTACT #6

Name

Position

Email Address

Direct/Cell Number