Non Foods/Pharmacy
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 event requests. If you do not receive a confirmation within 72 hours, contact the Scheduling Department immediately.

Please review your confirmation carefully.

Event Request

Billing Contact Information

* Vendor Name:

* Costco Vendor ID #:

Phone:

Fax:

* Person Placing Order:

* Email:

PO#:

Scheduling/Broker Information

(if different from Billing Contact Information)

Company Name:

Phone:

Fax:

Email:

Event Type Information

Request Type Schedule Cancel Change

Reason for Change:

(all changes must have an explanation so it can be communicated to your buyer)

Type of Event Regular Combo Split

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

Will your product be drop-shipped for the events? Yes No

If drop shipment is not received 24 hours prior to event, 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 want your products scheduled/changed:

* What is the number of event dates you would like to schedule in each location?:

Product Information

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

Select the stores where you want events scheduled/changed:

Only request clubs where your product is carried

Check/Un-Check All Stores:	Number of Stores Selected:

Puerto Rico

335 | Carolina 363 | East Baymon

364 | West Baymon 365 | Caguas

* Event Instructions:

Split Event Information:

If this is a split event & you already have a split partner, complete the following:

Split Partner:

Rep. Name:

Phone:

Fax:

Split Event Product Information

Product Name:	Costco Item #:
Substitute Product Name:	Costco Item #:

If this is a split event, can your product run alone at the full labor rate?

Yes No

Instructions for Split Events:

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Non Foods/Pharmacy
Scheduling Request Form

Note:

Billing Contact Information

Scheduling/Broker Information

Event Type Information

Split Vendor Program

* Date(s) you want your products scheduled/changed:

* What is the number of event dates you would like to schedule in each location?:

Product Information

Select the stores where you want events scheduled/changed:

Midwest Warehouses:

Northeast Warehouses:

San Diego Warehouses:

Southeast Warehouses

Texas Warehouses

Puerto Rico

* Event Instructions:

Split Event Information:

Split Event Product Information

Instructions for Split Events:

Marketing with a pulse.

Non Foods/Pharmacy Scheduling Request Form

Note:

Billing Contact Information

Scheduling/Broker Information

Event Type Information

Split Vendor Program

* Date(s) you want your products scheduled/changed:

* What is the number of event dates you would like to schedule in each location?:

Product Information

Select the stores where you want events scheduled/changed:

Midwest Warehouses:

Northeast Warehouses:

San Diego Warehouses:

Southeast Warehouses

Texas Warehouses

Puerto Rico

* Event Instructions:

Split Event Information:

Split Event Product Information

Instructions for Split Events:

Marketing with a pulse.

Non Foods/Pharmacy
Scheduling Request Form