Thanks for showing an interest in establishing an account with us. Please complete this form. Processing typically requires 5-7 business days to complete and will be acknowledged by email or a phone call. If you are paying on a C.O.D. basis, credit references are not required. Our standard account terms are Net 21 days.
[contact-form]
[contact-field label=’Credit Limit Requested’ type=’text’ required=’1’/]
[contact-field label=’Legal Company Name’ type=’text’ required=’1’/]
[contact-field label=’Company Name (if different from above)’ type=’text’/]
[contact-field label=’Street Address’ type=’text’ required=’1’/]
[contact-field label=’City’ type=’text’ required=’1’/]
[contact-field label=’Province’ type=’text’ required=’1’/]
[contact-field label=’Postal Code’ type=’text’ required=’1’/]
[contact-field label=’Telephone’ type=’text’ required=’1’/]
[contact-field label=’Fax Number’ type=’text’/]
[contact-field label=’Owner/Principal’ type=’text’ required=’1’/]
[contact-field label=’Contact’ type=’text’ required=’1’/]
[contact-field label=’Accounts Payable Contact’ type=’text’ required=’1’/]
[contact-field label=’Mailing Address (if Different from above)’ type=’text’/]
[contact-field label=’Bank’ type=’text’/]
[contact-field label=’Mailing Address’ type=’text’/]
[contact-field label=’Mailing City’ type=’text’/]
[contact-field label=’Mailing Contact’ type=’text’/]
[contact-field label=’Mailing Telephone’ type=’text’/]
References
Please include companies that you have credit with currently
[contact-field label=’Reference 1 Name’ type=’text’ required=’1’/]
[contact-field label=’Reference 1 Telephone’ type=’text’ required=’1’/]
[contact-field label=’Reference 1 Address’ type=’text’ required=’1’/]
[contact-field label=’Reference 1 Contact’ type=’text’ required=’1’/]
[contact-field label=’Reference 1 Fax’ type=’text’ required=’1’/]
[contact-field label=’Reference 2 Name’ type=’text’/]
[contact-field label=’Reference 2 Telephone’ type=’text’/]
[contact-field label=’Reference 2 Address’ type=’text’/]
[contact-field label=’Reference 2 Contact’ type=’text’/]
[contact-field label=’Reference 2 Fax’ type=’text’/]
[contact-field label=’Reference 3 Name’ type=’text’/]
[contact-field label=’Reference 3 Telephone’ type=’text’/]
[contact-field label=’Reference 3 Address’ type=’text’/]
[contact-field label=’Reference 3 Contact’ type=’text’/]
[contact-field label=’Reference 3 Fax’ type=’text’/]
[contact-field label=’I hereby state ALL of the above information is correct.’ type=’checkbox’ required=’1’/]
[/contact-form]