Become A Customer - Gordon Food Service
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<title>Become A Customer - Gordon Food Service</title>
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<body>
<header class="d-flex justify-content-between ms-4 mt-4 me-4">
<div class="logo"><a href="https://gfs.com/" title="Gordon Food Service"><img src="https://forms.gfs.com/sites/all/themes/gfs/logo.svg" alt="Gordon Food Service"></a></div>
<div>
<span class="nav-account">Have an account? </span> <a href="https://www.gfs.com/en-us/sign-in" class="nav-a fw-bold">Sign In</a>
<div id="switch-to-canada-nav" style="text-align:right;"><span class="nav-account">Switch to </span> <a href="https://forms.gfs.ca/en/signup/ca" class="nav-a fw-bold">Canada</a></div>
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</header>
<main class="container-fluid gx-0">
<div class="row mt-4 mb-5 me-0">
<div class="col-xl-5 pe-0">
<div class="bac-welcome shadow">
<h1 class="text-white fw-bolder mb-5">Become a Customer Today</h1>
<p>We have been driven by customers like you for over 125 years. As the largest family-owned business in foodservice, we do what we do best to help move your business forward, all while treating you like part of the family. Through excellence, expertise and quality foods, our destination is your success—no matter what that looks like to you. Let's get started.</p>
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<div class="col-xl-7 bac-form">
<form id="customer_form" novalidate>
<div class="accordion accordion-flush" id="accordionBAC">
<div class="accordion-item">
<h2 class="accordion-header" id="headingOne">
<button class="accordion-button" type="button" data-mdb-toggle="collapse" data-mdb-target="#collapseOne" aria-expanded="false" aria-controls="collapseOne">Tell Us About Yourself</button>
</h2>
<div id="collapseOne" class="accordion-collapse collapse show" aria-labelledby="headingOne" data-mdb-parent="#accordionBAC">
<div class="accordion-body">
<div class="row mb-4 g-3">
<div class="col-md-6">
<div class="form-outline">
<input type="text" class="form-control" name="first_name" id="first_name" required>
<label for="first_name" class="form-label">First Name*</label>
<div class="invalid-feedback">This Field is Required</div>
</div>
</div>
<div class="col-md-6">
<div class="form-outline">
<input type="text" class="form-control" name="last_name" id="last_name" required>
<label for="last_name" class="form-label">Last Name*</label>
<div class="invalid-feedback">This Field is Required</div>
</div>
</div>
</div>
<div class="row mb-4 g-3">
<div class="col-md-6">
<div class="form-outline">
<input type="text" class="form-control" name="role" id="role" required>
<label for="role" class="form-label">Role*</label>
<div class="invalid-feedback">This Field is Required</div>
</div>
</div>
<div class="col-md-6">
<div class="form-outline">
<input type="text" class="form-control" name="mobile" id="mobile" required>
<label for="mobile" class="form-label">Mobile Number*</label>
<div class="invalid-feedback">This Field is Required</div>
</div>
</div>
</div>
<div class="row mb-4 visually-hidden">
<div class="form-outline col">
<input type="text" class="form-control" name="url" id="url" tabindex="-1">
<label for="url" class="form-label">Please Leave This Field Blank</label>
</div>
</div>
<div class="form-outline mb-4">
<input type="text" class="form-control" name="email" id="email" required>
<label for="email" class="form-label">Email*</label>
<div class="invalid-feedback">A valid e-mail address is Required</div>
</div>
<div class="form-outline mb-4">
<input type="text" class="form-control" name="email_confirm" id="email_confirm" required>
<label for="email_confirm" class="form-label">Confirm Email*</label>
<div class="invalid-feedback">A valid e-mail address is Required</div>
</div>
</div>
</div>
</div>
<div class="accordion-item">
<h2 class="accordion-header" id="headingTwo">
<button class="accordion-button collapsed" type="button" data-mdb-toggle="collapse" data-mdb-target="#collapseTwo" aria-expanded="false" aria-controls="collapseTwo">Tell Us About Your Business</button>
</h2>
<div id="collapseTwo" class="accordion-collapse collapse" aria-labelledby="headingTwo" data-mdb-parent="#accordionBAC">
<div class="accordion-body">
<div class="form-outline mb-4">
<input type="text" class="form-control" name="business_name" id="business_name" required>
<label for="business_name" class="form-label">Business Name*</label>
<div class="invalid-feedback">This Field is Required</div>
</div>
<div class="row mb-4 g-3">
<div class="col-md-6 no-label">
<select class="select" name="business_type" id="business_type" data-mdb-validation="true" data-mdb-invalid-feedback="This Field is Required" required>
<option value="" disabled="disabled" selected="selected">Business Type*</option>
</select>
<label for="business_type" class="form-label select-label visually-hidden">Business Type*</label>
</div>
<div class="col-md-6 no-label">
<select class="select" name="business_subtype" id="business_subtype" data-mdb-validation="true" data-mdb-invalid-feedback="This Field is Required" required>
<option value="" disabled="disabled" selected="selected">Sub Type*</option>
</select>
<label for="business_subtype" class="form-label select-label visually-hidden">Sub Type*</label>
</div>
</div>
<div class="row mb-1 g-3">
<div class="col no-label">
<select class="select" name="supplier" id="supplier">
<option value="" disabled="disabled" selected="selected">Who is your existing supplier?</option>
<option>None</option>
<option>Ben E. Keith Foods</option>
<option>Cheney Brothers</option>
<option>Costco</option>
<option>Performance Food Group</option>
<option>Reinhart Foodservice</option>
<option>Restaurant Depot</option>
<option>Sam's Club</option>
<option>Shamrock Foods Company</option>
<option>Sysco</option>
<option>US Foods</option>
<option value="other">Other...</option>
</select>
<label for="supplier" class="form-label select-label visually-hidden">Who is your existing supplier?</label>
</div>
<div class="col-md-6" id="supplier_other_input" style="display: none;">
<div class="form-outline">
<input type="text" class="form-control" name="supplier_other" id="supplier_other" data-mdb-validation="true" data-mdb-invalid-feedback="This Field is Required" required>
<label for="supplier_other" class="form-label">Please Specify Supplier*</label>
<div class="invalid-feedback">This Field is Required</div>
</div>
</div>
</div>
<div class="">
<label class="form-label mb-1">Hours of Operation</label>
</div>
<div class="row mb-4 g-3">
<div class="col-md-6">
<div class="form-outline timepicker" data-mdb-with-icon="false">
<input type="text" class="form-control" name="hours_open" id="hours_open" data-mdb-toggle="timepicker" readonly="true" required>
<label for="hours_open" class="form-label">Open Time*</label>
<div class="invalid-feedback">This Field is Required</div>
</div>
</div>
<div class="col-md-6">
<div class="form-outline timepicker" data-mdb-with-icon="false">
<input type="text" class="form-control" name="hours_close" id="hours_close" data-mdb-toggle="timepicker" readonly="true" required>
<label for="hours_close" class="form-label">Close Time*</label>
<div class="invalid-feedback">This Field is Required</div>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="accordion-item">
<h2 class="accordion-header" id="headingThree">
<button class="accordion-button collapsed" type="button" data-mdb-toggle="collapse" data-mdb-target="#collapseThree" aria-expanded="false" aria-controls="collapseThree">Where Do You Need Delivery?</button>
</h2>
<div id="collapseThree" class="accordion-collapse collapse" aria-labelledby="headingThree" data-mdb-parent="#accordionBAC">
<div class="accordion-body">
<div class="form-outline mb-4">
<input type="text" class="form-control" name="delivery_address" id="delivery_address" required>
<label for="delivery_address" class="form-label">Delivery Address*</label>
<div class="invalid-feedback">This Field is Required</div>
</div>
<div class="row mb-4 g-3">
<div class="col-md-5">
<div class="form-outline">
<input type="text" class="form-control" name="city" id="city" required>
<label for="city" class="form-label">City*</label>
<div class="invalid-feedback">This Field is Required</div>
</div>
</div>
<div class="col-md-4 no-label">
<select class="select" name="state" id="state" data-mdb-validation="true" data-mdb-invalid-feedback="This Field is Required" required data-mdb-filter="true">
<option value="" disabled="disabled" selected="selected">State*</option>
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AZ">Arizona</option>
<option value="AR">Arkansas</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
<option value="CT">Connecticut</option>
<option value="DE">Delaware</option>
<option value="DC">District of Columbia</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="HI">Hawaii</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="IA">Iowa</option>
<option value="KS">Kansas</option>
<option value="KY">Kentucky</option>
<option value="LA">Louisiana</option>
<option value="ME">Maine</option>
<option value="MD">Maryland</option>
<option value="MA">Massachusetts</option>
<option value="MI">Michigan</option>
<option value="MN">Minnesota</option>
<option value="MS">Mississippi</option>
<option value="MO">Missouri</option>
<option value="MT">Montana</option>
<option value="NE">Nebraska</option>
<option value="NV">Nevada</option>
<option value="NH">New Hampshire</option>
<option value="NJ">New Jersey</option>
<option value="NM">New Mexico</option>
<option value="NY">New York</option>
<option value="NC">North Carolina</option>
<option value="ND">North Dakota</option>
<option value="OH">Ohio</option>
<option value="OK">Oklahoma</option>
<option value="OR">Oregon</option>
<option value="PA">Pennsylvania</option>
<option value="RI">Rhode Island</option>
<option value="SC">South Carolina</option>
<option value="SD">South Dakota</option>
<option value="TN">Tennessee</option>
<option value="TX">Texas</option>
<option value="UT">Utah</option>
<option value="VT">Vermont</option>
<option value="VA">Virginia</option>
<option value="WA">Washington</option>
<option value="WV">West Virginia</option>
<option value="WI">Wisconsin</option>
<option value="WY">Wyoming</option>
</select>
<label for="state" class="form-label select-label visually-hidden">State*</label>
</div>
<div class="col-md-3">
<div class="form-outline">
<input type="text" class="form-control" name="zip" id="zip" required>
<label for="zip" class="form-label">Zip Code*</label>
<div class="invalid-feedback">This Field is Required</div>
</div>
</div>
</div>
<div class="form-outline mb-4">
<textarea class="form-control" rows="3" name="special_needs" id="special_needs"></textarea>
<label for="special_needs" class="form-label">Please describe any special delivery or food service needs</label>
</div>
</div>
</div>
</div>
<div class="accordion-item" id="service_model" style="display: none;">
<h2 class="accordion-header" id="headingFour">
<button class="accordion-button collapsed" type="button" data-mdb-toggle="collapse" data-mdb-target="#collapseFour" aria-expanded="false" aria-controls="collapseFour">Give Our New Service Model a Try</button>
</h2>
<div id="collapseFour" class="accordion-collapse collapse" aria-labelledby="headingFour" data-mdb-parent="#accordionBAC">
<div class="accordion-body">
<ul>
<li>Quick Set-up and Onboarding</li>
<li>Credit Card Payment</li>
<li>Instant Text Support</li>
</ul>
<fieldset>
<legend class="visually-hidden">Service Sign Up</legend>
<div class="form-check">
<input type="radio" class="form-check-input" name="service_sign_up" value="yes" id="service_sign_up_yes" required>
<label class="form-check-label" for="service_sign_up_yes">Yes, Sign me up.</label>
</div>
<div class="form-check">
<input type="radio" class="form-check-input" name="service_sign_up" value="no" id="service_sign_up_no" required>
<label class="form-check-label" for="service_sign_up_no">No thanks, I'll continue getting setup with a Rep.</label>
</div>
</fieldset>
</div>
</div>
</div>
</div>
<div class="mt-4">
<button type="submit" class="btn btn-primary btn-lg" id="form_submit" disabled="disabled">Submit Form</button>
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<footer class="d-flex justify-content-between m-4">
<div></div>
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<form>
<h2 class="visually-hidden" id="headingLang">Language Select</h2>
<select class="select" name="languageSelect" id="languageSelect" aria-labelledby="headingLang">
<option value="us-en" selected="selected">English (US)</option>
<option value="ca-en">English (CA)</option>
<option value="ca-fr">French (CA)</option>
</select>
<label for="languageSelect" class="form-label select-label">Select Language</label>
</form>
</div>
</footer>
<!-- Modal -->
<div class="modal fade" id="thankyouModal" data-mdb-backdrop="static" data-mdb-keyboard="false" tabindex="-1" tabindex="-1" aria-labelledby="modalLabel" aria-hidden="true">
<div class="modal-dialog modal-dialog-centered">
<div class="modal-content">
<div class="modal-header visually-hidden">
<button type="button" class="btn-close" data-mdb-dismiss="modal" aria-label="Close"></button>
</div>
<div class="modal-body">
<h3 class="modal-title text-center p-3" id="modalLabel">Thank you for your interest.</h3>
<p class="text-center">Do you know we have Gordon Food Service Stores to supplement in between deliveries? Click <a href="https://gfsstore.com/locations/">here</a> to find the closest store to you.</p>
</div>
<div class="modal-footer">
<button type="button" class="btn btn-primary" id="redirectButton">Proceed to GFS.com</button>
</div>
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