Web Customer Application Sign Up Form

Complete and submit this request form to view order status for repairs, exchanges and service orders as well as pricing and availability.

Schneider Electric Industrial Repair Services
Customer Service
235 Burgess Road
Greensboro, NC 27409
Phone: 800.950.9550
Fax: 336.668.4878
Email: industrialrepair@schneider-electric.com

Fields with (*) are required.

BUSINESS CONTACT INFORMATION

Bill to Information


Purchaser Information (same as 'Bill to' Yes)


Ship to Information (same as 'Bill to' Yes)


Yes No
If No, please fax 336.668.4878 or email: industrialrepair@schneider-electric.com a tax exemption certificate with this form; must be made out to Schneider Electric USA, Inc.
Credit references must be supplied for open terms. Contact us for Credit Card or COD options.Please fax 336-668-4878 or email industrialrepair@schneider-electric.com must be supplied for open terms. Contact us for Credit Card or COD options.
Please fax 336.668.4878 or email industrialrepair@schneider-electric.com

*Your company is a Distributor End User

WEB OPTIONS

Our Industrial repair services website allows customers to view order status, pricing, service offerings, tracking information, createpacking slip, submit orders and more for any product sent to our Greensboro, NC facilities. Please providethe name, email and phone number for any interested parties (*at least one entry is required)

Name



Email



Phone



CONTACT INFO FOR JOBS/PRODUCTS REQUIRING A QUOTE

Preferred contact by Email Fax

AGREEMENT

  1. All invoices are to be paid 30 days from date of the invoice.
  2. By submitting this application, you authorize Schneider Electric USA, Inc. to make inquiries into the banking and business/trade references that you have supplied.
  3. The undersigned agrees to pay all collection costs, court costs and legal fees incurred to collect delinquent balances.
  4. By signing the authorized signature and submitting this application you accept terms of this agreement.

By checking this box, you agree to the terms above.

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