Electronic Commerce Application

Thank you for your interest in Office Management Systems. Please take a moment to complete the application below. We will call or email you with your password and/or account number when approved.

New account requests only: If you are requesting a new account to be established, you must fill out the "Financial Information" requested at the end of this form. We look forward to working with you.

Electronic Commerce Account Setup Form
Company Information - All requested information must be filled out in order to avoid delay.
 Are you a Current OMS Cutomer?- Yes - No
 Company Name:
 Purchasing Contact:
 Address:
 City, State & Zip:
Telephone Number:
Fax Number:
Email Address (required):
Designated Primary User Info
Primary User:
Primary Ship To Address:
Primary City, State & Zip:
Primary Email Address:
Purchase Order Required? - Yes - No
Cost Center Required? - Yes - No
Ship To Required? - Yes - No
Password (4 - 8 char.)
 Equipment Profile
PC Make and Model #:
Operating System: Win 95/98 Win NT Other
Browser: MS Explorer Netscape Other/Ver.

Financial Information for New Accounts
Financial Institution:
Contact:
Address:
City, State & Zip:
Telephone Number:
Account Number: 

Press "Submit" to send your request or "Reset" to clear 
all information.

You may Contact us by telephone or mail at:

Office Management Systems
PO Box 704
Stoughton, MA 02072
Phone: 781-297-9828
Fax: 781-341-0385

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