Customer Registration

For NEW Customers

The purpose of this Customer Registration form is for NEW customers to be able to set-up to order from Amerigrow. This includes the set-up with any of our divisions: Mulching Solutions, Amerigrow Soils, Amerigrow Trucking, Amerigrow Recycling and Amerigrow Golf.

Please fill out the information below. Upon submission of the form, we will set you up as a Sales Account and you will be able to start ordering. Please allow 24 hours for your Customer Registration form to process.

All customers are on a C.O.D. payment agreement unless your credit application has been submitted and approved. If you would like to open a payment account with Amerigrow, please fill out our Credit Application. Upon completion of this credit application, please fax it to our Delray Beach headquarters at the fax number: 561-499-5896 with attention to: Accounting/ Online Request. Please allow up to 5 business days for your credit application to be processed.

If you have any questions or concerns, please do not hesitate to contact one of our friendly and informative customer service representatives at the telephone number: 561-499-8148 or toll free: 1-800-860-8238.

* Required Fields

*How did you hear about us?

Company Information / Contact Information

*Company:

*Address:

*City:

*Phone:

Fax:

Website URL:

 

*First Name:

*Last Name:

Job Title:

Phone #1:

Phone #2

Email:

*Does your company require purchase orders?

*Would you like to receive your invoices and statements by email?

*Please check all counties we will service for you:

Indian River County (Debris Pick-up is the only service we DO NOT offer in this county)
St. Lucie County (Debris Pick-up is the only service we DO NOT offer in this county)
Martin County
Palm Beach County
Broward County
Dade County
Monroe County (Debris Pick-up is the only service we DO NOT offer in this county)
Sarasota County (Blow-on Installation is the only service we DO offer in this county)
Charlotte County (Blow-on Installation is the only service we DO offer in this county)
Lee County (Blow-on Installation is the only service we DO offer in this county)
Collier County (Blow-on Installation is the only service we DO offer in this county)

If your county is not listed, it is because Amerigrow does not offer this service in your area. Please call if you need further information.

*Please check all services you are interested in:

Bulk Product Delivery
Palletized Product Delivery
Blow-on Installation of Products
Vegetative Debris Pick-up Service

Notes: