NewPointe and Cremation Tiered Pricing Requests

Please complete this form if you are making an exception request for a customer. Be as detailed as possible to ensure this is a justified request and a prompt decision can be made to approve the request.
Rep Information (Name & Territory Number)*
Rep Name (First & Last) Territory Number
Hidden
First Name
Hidden
Last Name
Rep Email*
Regional Director Name*
Please select your Regional Director from the list below:
Account #*
Enter the account number and name of the firm you are requesting a promotion exception for.
Acct # Account Name
Customer Buying Program*
Please select which buying program this customer is currently on:
Does this account have any upfront payments/special allowances?*
Upfront Payments/Cash/Allowances*
Please specify any upfront payments, pre-bates or special allowances currently on this account.
Are you a US rep?*
Exception Requested (US)*
Please select which type of exception is being requested
Exception Requested (Canada)*
Please select which type of exception is being requested
Rolling 12 Burial Volume*
*Note: Cannot enter 0 as value. If do not have R12 data, please enter N/A or --.
Estimated Unit Growth through Factory Direct
Estimated Unit Growth through AMP 2.0
Should this customer receive Direct Marketing materials about Factory Direct?*
- Yes
- No
Tier 2 Collection*
- Solstice Cedar
Check the collection for which you are requesting to be added to Tier 2 NewPointe Price
Tier 3 Collections*
Check all collections for which you are requesting to be added to Tier 3 NewPointe Price
- Lunar Collection
- Aquarius
- Vega
- Virgo Collection
- Argo Collection
- Hercules-28 Gasketed
- Hercules-28 NGS
- Aries
- Pisces
- Spectra
- Gemini
- Apollo
- Libra
- Lyra
- Artemis
Tier 3 Collections - Canada*
Check all collections for which you are requesting to be added to Tier 3 NewPointe Price
- Lunar Collection
- Virgo Collection
- Argo Collection
- Hercules-28 Gasketed
- Hercules-28 NGS
- Aries
- Pisces
- Spectra
- Gemini
- Apollo
- Libra
- Lyra
- Artemis
Solstice Cedar*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T3 approved
Virgo*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T3 approved
Argo*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T3 approved
Hercules-28 Gasketed*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T3 approved
Hercules-28 Gasketed*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T3 approved
Aries*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T3 approved
Pisces*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T3 approved
Spectra*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T3 approved
Gemini*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T3 approved
Apollo*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T3 approved
Libra*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T3 approved
Lyra*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T3 approved
Aquarius*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T3 approved
Artemis*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T3 approved
Vega*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T3 approved
Lunar Collection*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T3 approved
Tier 4 Collection Groupings*
Check all groupings for which you are requesting to be added to the Tier 4 Newpointe Price.
- Aquarius
- Vega
- Non-Gasketed Collections (Apollo, Gemini, Spectra)
- 18 gauge Collections (Virgo)
- 20 gauge Collections (Argo, Aries, Pisces)
- Wood (Libra, Lynx, Lyra)
- Wood (Lunar Red, Lunar Brown)
- Hercules (Gasketed, NGS, and 32")
Tier 4 Collection Groupings - Canada*
Check all groupings for which you are requesting to be added to the Tier 4 Newpointe Price.
- Non-Gasketed Collections (Apollo, Gemini, Spectra)
- 18 gauge Collections (Virgo)
- 20 gauge Collections (Argo, Aries, Pisces)
- Wood (Libra, Lynx, Lyra)
- Wood (Lunar Red, Lunar Brown)
- Hercules (Gasketed, NGS, and 32")
Aquarius*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T4 approved
Vega*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T4 approved
Non-Gasketed Collections*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T4 approved
18 gauge Collections*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T4 approved
20 gauge Collections*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T4 approved
Wood Collection (Libra, Lynx, Lira)*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T4 approved
Wood Collection (Lunar Red, Lunar Brown)*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T4 approved
Hercules Collections*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T4 approved
Tier 5 Collection Groupings*
Check all groupings for which you are requesting to be added to the Tier 5 Newpointe Price.
- Apollo
- Gemini
- Spectra
- Hercules (28 gasketed)
Apollo*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T3 approved
Gemini*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T3 approved
Spectra*
*Note: Cannot enter 0 as value. If do not have R12 or volume data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T3 approved
Hercules-28 NGS*
*Note: Cannot enter 0 as value. If do not have R12 data, please enter N/A or --.
Enter Rolling 12 volume Enter estimated total volume if T3 approved
Tier Rental Caskets & Inserts
Enter Rolling 12 volume Enter estimated total volume if approved
REMINDER: AMP customers already get special pricing on rental caskets, rental inserts, and alternative containers. Likewise, all AMP customers are eligible for the tiered net pricing on urns. Any submissions for AMP customers will not be processed. *Rental Caskets & Inserts include: Beckham, Brockton, Linford, Crepe Inserts, Velvet Inserts *Alternative Containers include: Stratus, Standard, Standard Brown, Trayview
Tiered Cremation Containers, Caskets and Inserts
Check all collections for which you are requesting to be added to Tiered Container price.
- TIER 2 RENTAL CASKETS & INSERTS
- TIER 3 RENTAL CASKETS & INSERTS
- ALTERNATIVE CONTAINERS
TIER 2 Rental Caskets & Inserts
Enter Rolling 12 volume Enter estimated total volume if approved
TIER 3 Rental Caskets & Inserts
Enter Rolling 12 volume Enter estimated total volume if approved
Alternative Containers
Enter Rolling 12 volume Enter estimated total volume if approved
REMINDER: AMP customers are not eligible for the Tiered Container or Tiered Urn offer. Any submissions for AMP customers will not be processed.
Business Case*
Explain, in detail, why you are making an exception request for this customer.
AMP NOTICE:
I verify that have spoken with the customer, and the customer will be placed on the Access More Program upon submission of AMP 2.0 request. The customer is fully aware of the program terms.
Customer is aware all other programs will be ending and they will be set up on AMP 2.0 program. No outstanding fixturing or supply agreements and consignment is less than $5,000.
NOTICE:
Upon submission, I agree to send my RD a VPP parent report (detailed to product) and NewPointe Tiers.

Enter Rolling 12 volume	Enter estimated total volume if approved