Online Gift Baskets Membership Application


PLEASE CHECK HERE FIRST TO DETERMINE YOUR ELIGIBILITY

Personal Information:
First Name:
Last Name:

Street Address (Line 1):

Street Address (Line 2):
City:
State/Province:
ZIP/Postal Code:
Country:
Telephone:
 
Thinking about getting a website or redesigning your existing one?
Would you like to receive information regarding OGB's Web Design Packages? Yes No
 
Business Partner Information (If Applicable):
First Name:
Last Name:
Street Address (Line 1):
Street Address (Line 2):
City:
State/Province:
ZIP/Postal Code:
Country:
Telephone:
 
Business Information:
Business Name:
Incorporated :
Street Address (Line 1):
Street Address (Line 2):
City:
State/Province:
ZIP/Postal Code:
Country:
Telephone:
Fax:
Cellular:
E-mail Address:
Website Address:
GST Registration # (Canada & Australia Only):
Business Started (Year/Month):
Operates:
Operates:
Days of Operation:
Hours of Operation:
Local Delivery Charge:
Cutoff Time For Same Day Delivery (in your city):
Credit Cards Accepted (Check all that apply): VISA Mastercard Amex Discover NONE
Do you have a Paypal account? Yes No
What is your password preference for our "Member's Only" Area?
 
 
In addition to my "Primary" Location (that's the city of your physical location), I would like to represent the following "Secondary" Communites (click here for expanation of secondary community) to which I also provide same business day, hand delivery.
 
Secondary Location
Cut Off Time For
Same Day Delivery
Delivery Charge
  
$
 
$
 
$
 
$
 
$
 
$
 
$
 
$
 
$
 
$
 
 
Which types of baskets can you provide (usually) from your existing inventory (check all that apply):
Baby Pamper Fruit Gourmet Food
Regular Snack Candy Chocolate Coffee
Pasta BBQ Kosher Toys
Balloons Magazines Crossword Puzzles Gourmet Snack
Tea Plush Toys Adult Novelty Other
       
Which types of baskets can you provide (usually) by out-purchasing the needed products (check all that apply):
Baby Pamper Fruit Gourmet Food
Regular Snack Candy Chocolate Coffee
Pasta BBQ Kosher Toys
Balloons Magazines Crossword Puzzles Gourmet Snack
Tea Plush Toys Adult Novelty Other
 
Do you stock theme containers? (i.e. golf, new home, thanks a million, etc.):
 
We can include alcohol (please check one):
Yes, I maintain an inventory
Yes, I wil out-purchase for a small service charge
Yes, I will pick it up for a small service charge, but only if I don't have to buy it
No, I will not at all
 
Please include any additional information on baskets you offer here:
 
Permissions to Online Gift Baskets:
I authorize Online Gift Baskets to select and copy of those gift baskets on my website so as to use them exclusively for jury purposes and ultimately for the production and uploading of my Member Product Web Page upon my approval and acceptance for Membership in Online Gift Baskets.