Welcome to the BRIGHTPOINT® Interface
Customer/Shipping Information:
Account No. CGSA: RAL WIL HKY GVL FAY NRF SFL TRI GRB RMT GNC First Name Last Name Organization Address 1 Address 2 City State Zip CBR 1 CBR 2
CGSA:
Last Name
State
CBR 2
Please provide the following product information:
Phone 1 Select Phone Motorola 120e Motorola V60i MIN 1 Select Status New Line Upgrade Exchange 1yr 2yr Price 0.00 19.95 29.95 39.95 49.95 59.95 79.95 129.95 Other Phone 2 Select Phone Motorola 120e Motorola V60i MIN 2 Select Status New Line Upgrade Exchange 1yr 2yr Price 0.00 19.95 29.95 39.95 49.95 59.95 79.95 129.95 Other Phone 3 Select Phone Motorola 120e Motorola V60i MIN 3 Select Status New Line Upgrade Exchange 1yr 2yr Price 0.00 19.95 29.95 39.95 49.95 59.95 79.95 129.95 Other Phone 4 Select Phone Motorola 120e Motorola V60i MIN 4 Select Status New Line Upgrade Exchange 1yr 2yr Price 0.00 19.95 29.95 39.95 49.95 59.95 79.95 129.95 Other
MIN 1
Please identify and describe yourself:
Name Agent ID: Extension:
Agent ID:
Extension:
Select enter any additional information regarding order:
