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Please feel free to fill out an application for credit.

For your convenience, we have made a printable version available in both PDF and WORD formats. Alternately, you may apply online here.




You will need Adobe Acrobat Reader for the pdf files.

Application for Credit ( Microsoft Word - Size: 28 KB )

Application for Credit ( PDF - Size: 8.53 KB )





* denotes a required field
Full Name *
 
Address *
 
Postal Code *
 
Phone Number *
 
Fax Number:
 
Email:
 
Affiliated With:

 

Type of Business:
 
If Other Please Specify:
 
Type of Products Sold:
 
Number of Employees *
 
Person in Charge *
 
Business is a *
 
If Partnership, names of Principals:
 
If Corporation, date incorporated:
 
Accounts Payable Contact *
 
Purchase Order Number Required *
 
Term of Blanket:
 



   
Financial Information ( if applicable )

Sales Volume Last Year:
 
Estimated Net Worth:
 
Have you ever been denied credit:
 
If yes, please explain:
 
Have you ever declared bankruptcy, or been a party of bankruptcy proceedings:
 
If yes, please explain:
 


References ( Bank and Trade )


Bank *
 
Bank Address *
 
Phone Number *
 
Person to Contact:
 

Note that three (3) Trade References are required

Trade References

   
Name *
 
Phone *
 
Address:
 
Fax Number:
 
City:
 
Province:
 
Code:
 
     
   
Name *
 
Phone *
 
Address:
 
Fax Number:
 
City:
 
Province:
 
Code:
 
     
   
Name *
 
Phone *
 
Address:
 
Fax Number:
 
City:
 
Province:
 
Code:
 


   
Credit Requirements
   
Approximate monthly credit requirements from us
 

Please list all authorized purchasing agents:
1.
 
2.
 
3.
 
4.
 
   

Upon credit being granted, a signature will be required to verify agreement with the following terms.

Net 30 days from date of invoice.

2% per month on outstanding balances ( 24% per annum )







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