ASM, Inc update form sc

QVC

Affiliate System Contact Update Form

Directions: Fill in this form to update your current system contact information. Print this form and fax to 484.701.1350.

System Information:

System Name:
Office Address/PO Box:
City: State: Zip:
Phone: - - Ext.: Fax: - -

Contact Information:

General Manager:
Office Address/PO Box:
City: State: Zip:
Phone: - - Ext.: Fax: - -
E-Mail:

Marketing Manager:
Office Address/PO Box:
City: State: Zip:
Phone: - - Ext.: Fax: - -
E-Mail:

Marketing Coordinator:
Office Address/PO Box:
City: State: Zip:
Phone: - - Ext.: Fax: - -
E-Mail:

Print this form and fax to 484.701.1350. Thank You!