ACCOUNT APPLICATION FORM

Before you can place an order, you must have an account with us. To open an account, please fill in the form below, print it, sign it, and return it to us by fax at 819-362-8603. We will send you your account number after checking your information.
Please note that your signature is required to enable us to make a credit check if need be.

Company name:

Registration number:

GST number:

PST number:

Name of owner:

Name of person in charge of purchases:

Name of person in charge of payables:

Address:

Province: Postal code:

Telephone: Fax:

E-mail:

How long have you been in business?

Financial Institution

Name:

Address:

Province: Postal code:

Telephone: Fax:

Account No:

Suppliers

Name:

Telephone: Fax:

 

Name :

Telephone: Fax:

 

Name :

Telephone: Fax:

 

VERY IMPORTANT

Signature:

Please return by fax: 819-362-8603