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New Customer | Sysco & Rouxbe Online Culinary Training
Sysco Customer Onboard Form
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1.
Please provide your facility, community, or company name.
(Required.)
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2.
What is your first name?
(Required.)
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3.
What is your last name?
(Required.)
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4.
What is your title?
(Required.)
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5.
Please provide your email address. Please check for accuracy as this is the primary communication method.
(Required.)
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6.
Please provide your phone number
(Required.)
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7.
Please provide your Sysco Operating Site location name.
(Required.)
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8.
Please provide your Sysco representative's name.
(Required.)
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9.
Please provide your Sysco representative's email.
(Required.)
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10.
Please provide your Sysco account number.
(Required.)
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11.
Please provide the street address of the facility.
(Required.)
Address
Address 2
City/Town
State/Province
ZIP/Postal Code
Country
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12.
Please provide the type of facility.
(Required.)
Acute Care
Assisted living/Independent Living
Long term Care
Continuing Care Retirement Community
Rehab
Restaurant
Other
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13.
Approver/Admin/ED Name
(Required.)
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14.
Approver/Admin/ED Email
(Required.)
15.
Package Choosen
Sysco Branded Individual Access | 1-10 Users
White-Labeled Platform | 11-20 Users $2500 Annually
White-Labeled Platform | 11-49 Users $5000 Annually
White-Labeled Platform | 50-9 Users $10000 Annually
Custom Platform
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16.
If you selected the Sysco Branded option, how many user licenses are you purchasing?
(Required.)
