Request Business Account

Complete the form below to apply for a North X shipping account

Primary Contact Person

First Name *

Last Name *

Job Title

Email Address *

Phone Number *

Street Address *

Address Line 2

City *

Country *

State/Province *

Postal Code *

Estimated Monthly Shipments

Average Shipment Value

Primary Shipping Routes

Business Reference 1

Business Reference 2

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Additional Notes or Special Requirements

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