• Customer Portal
  • Online Ordering
  • Bill Payment
  • Product Catalog
    • Big M Gourmet Express
    • Exclusive Brands
  • Equipment and Supplies
  • MealTicket Signup
Logo Logo Logo Logo Logo
  • Careers
  • COVID-19 Information
  • About Us
    • Contact Us
  • Become a Customer
    • Customer Application
  • Partnerships
    • Marketing Partner Information Update
  • Responsibility
    • Food Safety
    • Safety Data Sheets
    • Sustainability
  • Service Area
  • Solutions
    • Crispy Chick & Fish
    • Ideas and Innovations
    • National and Program Accounts
    • Nutrition Services
    • Receiving Appointments
  • Careers
  • COVID-19 Information
  • About Us
    • Contact Us
  • Become a Customer
    • Customer Application
  • Partnerships
    • Marketing Partner Information Update
  • Responsibility
    • Food Safety
    • Safety Data Sheets
    • Sustainability
  • Service Area
  • Solutions
    • Crispy Chick & Fish
    • Ideas and Innovations
    • National and Program Accounts
    • Nutrition Services
    • Receiving Appointments

Customer Application

1 Name and Email
2 Billing
3 Shipping
4 Customer Details
5 Owners
6 Banking & Accounts Payable
7 References
8 Sign and Complete
  • Thank you for your interest in becoming a customer of Merchants Foodservice.

    Before getting started, please provide your full name and a valid email address.
  • Please enter the Name and/or DSR number of your Merchants Sales Rep, if you know it.
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  • In the following form, please provide your Billing information.

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  • In the following form, please provide your Shipping information.

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  • In the following form, please provide more details about your company.

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  • Add all of the owners of your company. Use the 'Add Another Owner' button to add more.

  • Owner #1

  • Accepted file types: jpg, tga, png, gif, pdf, tif.
    Upload a copy of your Driver's License here
  • Owner #2

  • Accepted file types: jpg, tga, png, gif, pdf, tif.
    Upload a copy of your Driver's License here
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  • Provide both accounts payable and banking information here.

  • Accepted file types: jpg, tga, png, gif, pdf, tif.
    Upload a copy of your Sales Tax Certificate here
  • ACH Debit Authorization

    The purpose of this form is to authorize electronic debit transactions.
  • Accepted file types: jpg, gif, jpeg, png, tga.
  • I hereby authorize Merchants FoodService to initiate a charge (debit) entry at the Financial Institution indicated above, and initiate adjustments (if necessary) for any transactions debited in error. I agree that each payment shall be the same as if it were an instrument personally signed by me. This authority is to remain in effect until revoked by me in writing.

    I understand, that both the Financial Institution and Merchants FoodService reserve the right to terminate this payment plan.
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  • Add any trade references here, preferably food distributors. Use the 'Add Another Reference' button to add more.

  • Section Break

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  • Read the terms and conditions agreement before signing and submitting the form.

    Please review the application for accuracy before continuing to the next step. After clicking the Sign & Complete button, you will not be able to modify the contents of the application. To verify accuracy you may navigate through the form using the navigation buttons or by clicking the section headings.
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Post Office Box 1351 (39403)

1100 Edward Street
Hattiesburg, MS  39401

Phone (601) 583‑4351
Fax (601) 582‑5333

  • Employee HelpDesk
  • Employee Intranet
  • Employee Self Service
  • Remote Sales Support

Meal Ticket

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