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Blue Technologies Customer Number:   (from a recent invoice)       Authorized Buyer Information: (Every Authorized Buyer Must Enroll Individually)       First Name: Required Last Name: Required Phone Number: Required Email Address: Required Company Name: Required Bill-to Street Address:  Required Bill-to City: Required Bill-to State:  Required Bill-to ZipCode:   Required       Are You Tax Exempt? No Yes  If Yes, please fax a copy of your Tax Exempt Certificate to 330-523-3001   Ship-To Information  Check if same as Bill-To. If different than Bill-To, please complete the fields below   Ship-to Street Address:   Ship-to City:   Ship-to State:   Ship-to ZipCode:         Any comments, additional ship-to addresses or special instructions (optional):