New Customer Form

//New Customer Form
New Customer Form2019-01-31T22:59:57+00:00

Please take time to fill out our new customer form. This helps us get to know you and speeds up future orders. If you have any questions, please don’t hesitate to contact us.

Customer Type

Feature FilmTV ProductionCommercial Prod

StageRental HouseStudioSchool



Primary Address

Use As Ship To?

Billing Address

Same As Primary

Tax Status



Credit Card Authorization

AmexMaster CardVisa

Same As Primary

I authorize Los Angeles Rag House Inc, to charge the above credit card for payment of rental or purchase fees.

Please upload a copy of your Resale Certificate here: