Signup Form

Email*

First name*

Last name*

Company name*

Street address*

City*

State/Region*

Country/Region*

Phone number*

Accounting Contact*

Accounting Email*

Yard management System*

Product(s) you are signing up for*

EZ-Route

EZ-Runner

EZ-QC

EZ-Intel

SmartCycle

Billing Account Update

Cross Dock Collaboration (CDC)

ACH Billing Info

I (we) hereby authorize EZ-Management Solutions to initiate debit entries and to initiate, if necessary, credit entries and adjustments for any debit entries in error to my (our) Checking/Savings account for membership fees and additional invoices when appropriate.

Depository Name*

Bank Name

Bank Address*

City, State, Zip

Checking/Savings*

Checking

Savings

Routing Number*

Account Number*

Start date