This application must be completed in full for all types of accounts: Prepay, C.O.D. and Credit Cards. Credit Card accounts must have Credit Card Billing Authorization Form completed.

Business Information

A business name is required.
Valid first name is required.
Valid last name is required.
Valid address is required.
Valid city is required.
Please provide a valid state.
Zip code required.
Valid business phone is required.
Valid mobile number is required.
Valid fax is required.
Please enter a valid email address.

Type of Account Requested

Shipping Preference


Credit Card Authorization

Fill out credit card authorization and e-mail to sales@altcolorlab.com

Texas Resale Certificate

Texas Residents Only: fill out Texas resale certificate and e-mail to sales@altcolorlab.com


We/I agree to notify immediately in writing of any changes of ownership. If granted credit, I agree to pay all invoices according to your terms. Any communications concerning disputed debts, including an instrument tendered as full satisfaction of a debt, are to be sent to Ark-La-Tex Color Lab, Attn.: Accounts Receivable Dept., P.O. Box 1563, Longview, TX 75606. Submitting any media to Ark-La-Tex Color Lab for processing, printing or other handling constitutes an AGREEMENT by you that any damage or loss by our company, subsidiary or agents will only entitle you to replacement with a like amount of media is without other warranty or liability and recovery for any incidental or consequential damages is excluded. Ark-La-Tex Color Lab shall not be liable for any losses, damages or expenses, whether direct or consequential, due to or caused by delays in delivering a processed or printed product of Ark-La-Tex Color Lab to the customer.

Date is required
Signature is required