Nordlie

For full access to our website, please fill in the registration form below. You will receive a confirmation email. Please follow the links in this email to complete the WEBSITE REGISTRATION process.

Please fill in the form below and send us the attached forms that apply via fax, mail or email.

New Customer Data Form

MI Tax Form

Fax: (586) 755-0460

Mailing Address: 25300 Guenther Rd. Warren, MI 48091

Email: Bsuiter@nordlie.com

Registration

Company Name:	*
Username:	*
E-mail:	*
Password:	*
Verify Password:	*

Enter your Tax Id

ADDRESS

Billing   Contact Address City State Zip Country Phone Fax Shipping ( if not same as Billing) Company Address City State Zip Country Phone Fax Memo

DOCUMENTATION

Additional Documents Submited Customer Form No Yes Tax Form No Yes

COMPANY INFORMATION

Company Type Places of Business Floral Shop No Yes Gift Company No Yes Other Store Front No Yes Warehouse Facility No Yes Work out of Home No Yes Web Store No Yes   Web Address

You will receive a confirmation email once your account is approved

Salesman
Credit Limit
Price List
Farm Direct Markup %(i.e. 40.00)
Show Farms	No Yes
Allow Direct PO	No Yes

Fields marked with an asterisk (*) are required. Register