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Customer Application

Serendipity Wines New Customer Application

Looking to create a buyer account with Serendipity Wines? You've come to the right place. Please fill out all of the fields below to start the process.

Application Status

NOTE: This status and notes are related to this application and do not affect NetSuite or any user's website status.

Notes

Your Information

Your Name(Required)

Your Email(Required)

Business Details

Business Name(Required)

DBA

Location of your business(Required)

Select the location of your business.

California

Texas

Market Area(Required)

Select the market area of your business.

Type of Establishment(Required)

Select the type of your establishment.

Preferred Delivery Days(Required)

Select your preferred delivery days.

Monday

Tuesday

Wednesday

Thursday

Friday

Delivery Time(Required)

Select your delivery window

Delivery Notes

Preferred Serendipity Wines Salesperson(Required)

I have a preferred sales person.

I don't have a preferred sales person.

I don't remember their name

Serendipity Wines Sales Rep(Required)

Licensing Information

ABC License Type(Required)

ABC Expiration Date(Required)

MM slash DD slash YYYY

ABC License #(Required)

Tax ID Number(Required)

Tax Exempt

Yes

No

Business Location

Delivery Address(Required)

Street Address Address Line 2 City State ZIP Code

Primary Contact Information

Primary Contact(Required)

Use the name found on your liquor license

First Last

Primary Contact Job Title

Primary Contact Email Address(Required)

Send Statements to this Email

Use this email address

Primary Contact Phone Number(Required)

Primary Contact Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Customer Portal Access (Primary Contact)

Gain access to vital purchase order history and invoices.

Yes

No

Billing Contact Information

Same as Primary Contact(Required)

Yes, same as Primary Contact

No, different person

Billing Contact Name(Required)

This contact will receive billing & invoices

First Last

Billing Contact Job Title

Billing Contact Email Address(Required)

Send Statements to this Email

Use this email address

Billing Contact Phone Number(Required)

Billing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Customer Portal Access (Billing Contact)

Gain access to vital purchase order history and invoices.

Yes

No

Billing Questions

FinTech Account

Website Customer Portal Access

Gain access to vital purchase order history and invoices

Other Contact Information

Other Contact Name

First Last

Other Contact Job Title

Other Contact Role

Other Contact Email

Send Statements to this Email

Use this email address

Other Contact Phone

Consent(Required)

By hitting the Submit button, I confirm that all of the information is true and reflects my business correctly.

Δ

Texas & Serendipity Imports

9101 Wall St.
Building 10, Suite 1030
Austin, TX 78754
(512) 821 2105

California

114 New Mohawk Road
Suite #D
Nevada City, CA 95959
(530) 265 0300 ext: 204

Newsletter Sign Up

Your Name(Required)

Company Name

Email(Required)

Markets

Affiliation

Current Customer

Current customer?

Δ

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