New Client Form

Billing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Shipping Address

If different from billing address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Main Contact Name *

First Name

Last Name

Main Contact Phone Number *

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Billing Contact Name *

First Name

Last Name

Billing Contact Phone Number *

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What services are you interested in? *

High Performance Computing & AI Solutions

Data Center Solutions

SMB IT Support

SMB IT Procurement

Would you like to apply for a credit line with us? *

Customers who do not have an established line of credit with Images et Technologie are required to pay at the time of purchase using a credit card, cash, or on-site debit. If you have applied for credit terms, a member of our Credit Team will be in touch shortly to complete your application.

Yes

No

Acknowledgment Statement *

I confirm that the information provided above is accurate and complies with our billing requirements.

Yes