Japan Scheduling Request Form

Requests should be made at least two weeks prior to the requested date(s). Note: This lead time does not guarantee spaces available for your requested dates. You will receive an email/fax confirming your demo requests. If you do not receive a confirmation within 24 hours, contact the Scheduling Department immediately. Please review your confirmation carefully.

Billing Information
Scheduling/Broker Contact Information
(if different from above)

* Vendor Name: Company Name:

* Costco Vendor ID #: Phone:

Phone: FAX:

FAX: E-mail:

* E-mail:

* Person Placing Order:

PO#:

Choose one:	Schedule Cancel	REASON FOR CANCEL: (all cancels must have an explanation so it can be communicated to your buyer)
Choose one:	Regular Combo Split

If this is a combo demo, can one of your products run alone at a regular demo if product shortage occur?	Yes No
If this is a split demo, can your product run alone at the full labor rate?	Yes No
Will your product be drop-shipped for the demos?	Yes No
If drop shipment is not received 24 hours prior to demo, may we purchase?	Yes No

* Split Vendor Program

Are you interested in the Split Vendor Program?	Yes No
By selecting Yes, your Name, Item Description, Item Number, Phone Number and Email Address will be added to our Master Split Vendor List.

* Date(s) you wish your product scheduled/canceled

Product Information

* Product Name:		* Costco Item #:
Product Name:		Costco Item #:

Select the warehouses where you want demos scheduled/changed

ONLY REQUEST CLUBS WHERE YOUR PRODUCT IS CARRIED

860 Tamasakai

861 Amagasaki

862 Kanazawa Seaside

863 Kawasaki

864 Sapporo

865 Iruma

876 Hisayama

877 Makuhari

5150 Shinmisato

5153 Kyoto Yawata

5154 Zama

5155 Maebashi

5156 Kobe Seishin

SCHEDULE ALL WAREHOUSES? Yes No

* Instructions

Split Demo Information

If this is a SPLIT DEMO and you ALREADY have a split partner, complete the following:

Split Partner:

Rep. Name:

Phone:

FAX:

Product Name: Costco Item #:

Substitute

Product Name:
Costco Item #:

* Can the product run alone at the full labor rate? Yes No

Billing Information			Scheduling/Broker Contact Information (if different from above)
* Vendor Name:			Company Name:
* Costco Vendor ID #:			Phone:
Phone:			FAX:
FAX:			E-mail:
* E-mail:
* Person Placing Order:
PO#: