{"id":66961,"date":"2024-11-06T21:08:56","date_gmt":"2024-11-06T21:08:56","guid":{"rendered":"https:\/\/citypallets.ca\/cpwp\/?page_id=66961"},"modified":"2024-11-12T22:39:36","modified_gmt":"2024-11-12T22:39:36","slug":"vendor-affiliate-form","status":"publish","type":"page","link":"https:\/\/citypallets.ca\/cpwp\/vendor-affiliate-form\/","title":{"rendered":"New Affiliate \/ Vendor Form"},"content":{"rendered":"<div class=\"vgblk-rw-wrapper limit-wrapper\">\n\n\t<style>\n    .testing_22 {\n        background-color: #000;\n    }\n    .grey-bg-form {\n        background-color: #dddddd;\n        padding:3px;\n        text-align: center;\n        margin-bottom: 10px;\n    }\n    .signature-pad {outline: #999 1px solid;\n    }    \n<\/style>\n\t<p>Any issues filling out the form? Please get in touch with us at <a href=\"mailto:contact@citypallets.ca\">contact@citypallets.ca<\/a><\/p>\n<p><em>Fields marked with an asterisk (*) are mandatory.<\/em><\/p>\n\t\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f66963-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"66963\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/cpwp\/wp-json\/wp\/v2\/pages\/66961#wpcf7-f66963-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"66963\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f66963-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<div style=\"background-color: #0d793d; padding: 3px; text-align: center; margin-bottom: 10px;\">\n\t<h3 style=\"text-align: center; color: #fff;\">SECTION A: CONTACT INFORMATION\n\t<\/h3>\n<\/div>\n<div class=\"content-column one_half\">\n\t<p><label> Company Legal Name*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-legalname\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-legalname\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Company Trade Name*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-tradename\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-tradename\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<p><label> Address*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-companyaddress\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-companyaddress\" \/><\/span> <\/label>\n<\/p>\n<div class=\"content-column one_half\">\n\t<p><label> Contact Person*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-contactname\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-contactname\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<p><label> Authorized Contact Telephone Number*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"tel-contacttelnumber\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"tel-contacttelnumber\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half\">\n\t<p><label> Business Number*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-businessnumber\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-businessnumber\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Payment Term*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-paymentterm\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-paymentterm\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"content-column one_half\">\n\t<p><label> Is the business or corporation sales tax registrant?* <span class=\"wpcf7-form-control-wrap\" data-name=\"salestax\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"salestax\"><option value=\"Select\">Select<\/option><option value=\"Yes\">Yes<\/option><option value=\"No\">No<\/option><\/select><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<p><label> Tax Registration Number*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-taxnumber\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-taxnumber\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<p><label> Method of Payment (If EFT, please complete Section B below)*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-methodpayment\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-methodpayment\" \/><\/span> <\/label>\n<\/p>\n<div style=\"background-color: #0d793d; padding: 3px; text-align: center; margin-bottom: 10px;\">\n\t<h3 style=\"text-align: center; color: #fff;\">SECTION B: BANKING INFORMATION FOR EFT\n\t<\/h3>\n<\/div>\n<p><span>PLEASE ATTACH A COPY OF A VOID CHECK WHEN SUBMITTING THIS FORM USING THE UPLOAD DOCUMENT FEATURE IN SECTION C BELOW<\/span>\n<\/p>\n<div class=\"content-column one_half\">\n\t<p><label> Financial Institution<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-financeinstitution\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-financeinstitution\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Financial Institution Address<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-financeaddress\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-financeaddress\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"content-column one_half\">\n\t<p><label> Name on Bank Account:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-nameonaccount\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-nameonaccount\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Bank Code \/ Institution Number:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-bankcode\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-bankcode\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<p><label> Branch \/ Transit Number:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-branchnumber\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-branchnumber\" \/><\/span> <\/label>\n<\/p>\n<p><label> Account Number:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-accountnumber\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-accountnumber\" \/><\/span> <\/label>\n<\/p>\n<div style=\"background-color: #0d793d; padding: 3px; text-align: center; margin-bottom: 10px;\">\n\t<h3 style=\"text-align: center; color: #fff;\">SECTION C: REMITTANCE INFORMATION\n\t<\/h3>\n<\/div>\n<div class=\"content-column one_half\">\n\t<p><label> Accounts Receivable Contact*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-accountrcontact\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-accountrcontact\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Phone Number*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"tel-phonenumber\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"tel-phonenumber\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<p><label> Email Address*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"emailaddress\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"emailaddress\" \/><\/span> <\/label>\n<\/p>\n<div class=\"content-column one_half\">\n\t<p><label> Authorized Name*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-seccauthname\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-seccauthname\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<p><label> Authorized Title*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-authorizedtitle\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-authorizedtitle\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<p><label> Date*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"datetoday\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"datetoday\" \/><\/span> <\/label>\n<\/p>\n<p><label> Document Upload<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"file-667\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file\" accept=\"audio\/*,video\/*,image\/*\" aria-invalid=\"false\" type=\"file\" name=\"file-667\" \/><\/span><br \/>\n<\/label>\n<\/p>\n<p><span>We declare that the above information is true, correct and complete. <\/span><br \/>\n<input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Submit\" \/>\n<\/p><p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"_wpcf7_ak_\"><label>&#916;<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"230\"\/><script>document.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );<\/script><\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n\n<\/div><!-- .vgblk-rw-wrapper -->","protected":false},"excerpt":{"rendered":"<p>Any issues filling out the form? Please get in touch with us at contact@citypallets.ca Fields marked with an asterisk (*) are mandatory.<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"inline_featured_image":false,"footnotes":""},"class_list":["post-66961","page","type-page","status-publish","hentry"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/citypallets.ca\/cpwp\/wp-json\/wp\/v2\/pages\/66961","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/citypallets.ca\/cpwp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/citypallets.ca\/cpwp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/citypallets.ca\/cpwp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/citypallets.ca\/cpwp\/wp-json\/wp\/v2\/comments?post=66961"}],"version-history":[{"count":7,"href":"https:\/\/citypallets.ca\/cpwp\/wp-json\/wp\/v2\/pages\/66961\/revisions"}],"predecessor-version":[{"id":67024,"href":"https:\/\/citypallets.ca\/cpwp\/wp-json\/wp\/v2\/pages\/66961\/revisions\/67024"}],"wp:attachment":[{"href":"https:\/\/citypallets.ca\/cpwp\/wp-json\/wp\/v2\/media?parent=66961"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}