Cooper Booth registration form

Please fill out this form.

(*) Required fields.

Contact information
Name*
First Last
Title*

What is your job title / role at your organization?
Email address*
Enter Email Confirm Email
Phone number*
FAX
Account information
Organization name (participating member)*
Address*
Street Address City State ZIP Code
Phone number*
FAX
Organization type
Select your organization type*
Food purchasing
If you are interested in the Cooper Booth / Premier Foodservice program please provide the following information:
Estimated Annual Foodservice Purchases: $
Current Foodservice Distributor(s)
Average Daily Sales Outstanding (account payable terms)
Scheduled Food Deliveries Per Week
Average Food Drop Size: $
Are you interested in other contract categories?
Check all that apply.
- Office supplies
- Copiers / print services
- Background checks
- Janitorial supplies
- Furniture
- Facilities / construction
- Foodservice equipment
- Other
Additional ship to locations or sites
If your agency has multiple locations that would access any or all of the GPO contracts, please download and complete this spreadsheet template ("Schedule 1") and email it to Premier to ensure that they are linked to the program.
Terms and conditions
I agree to the Terms and Conditions of participation on behalf of the Participating Member and all facilities listed on Schedule 1.
I agree to the terms and conditions.*
- Yes

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Contact information