Volume Discount Application

Complete the entire form. You must complete all sections or the order will be declined.

In the Description field describe the following:

• Type of Business
• Years in Business

If you have already been accepted by Ambient and would like to submit a purchase order, please fill out our Purchase Order Form.

Note: Volume discounts start at $1,000 on select items only.

---

Your Name:
Contact Email:
Company Name:
Is this a GSA Order?*:
Shipping Address*:   Street Address City, State and Zip
Telephone:
Quantity:
Describe the following:   Type of Business Years in Business
Describe the following:   Products (sku number)
Payment Method (credit card, purchase order, etc)*:

---

If you cannot complete this form, please send all information indicated to: support@AmbientWeather.com