New Account Form

We will contact you to confirm and to set up a customized business form to make regular online ordering easier. There is no order minimum and shipping is FREE on web orders over $100. Payment terms are net 30-days from date of purchase. There is a $45 late fee on payments not received by invoice due date. For more information visit our FAQ webpage or call our office at 913-980-5245.

*First Name
*Last Name
*Company
*Zip Code
*E-mail
*Phone

Preferred Method of Payment	Invoice (terms of net 30-days) Credit Card

Business Industry

Business Size

Do you currently use a First Aid & Safety Service?	Yes No

Are you a current Kansas City First Aid Customer?	Yes No

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