Application for Contractor Account

Contractor Registration Form

NOTE: THIS IS NOT AN APPLICATION FOR CREDIT. ALL NEW ACCOUNTS REQUIRE PREPAYMENT PER ORDER. C.O.D. AND CREDIT TERMS MAY BE NEGOTIATED UPON GOOD PAYMENT HISTORY

OWNER INFORMATION

Your Name

Title:

Email:

Phone:

BUSINESS INFORMATION AS REGISTERED

Company Name:

Company Address:

Phone:

City:

Province

Postal Code:

Date Business Started

Type of Business

BUSINESS SHIP TO ADDRESS IF DIFFERENT THAN ABOVE

Company Address:

Phone:

City:

Province

Postal Code:

ACCOUNTING INFORMATION

A/P Contact Name:

A/P PHONE

A/P Email:

PST Exempt #:

Credit Amount Requested:

CONTACT INFORMATION – NAME & EMAIL

Order Acknowledgments:

Invoices / Credits

BUSINESS REFERENCES

Please provide us at least two other companies your business has established credit with previously.
Note: GLASS SUPPLIERS WILL NOT BE ACCEPTED AS A REFERENCE.

1 | Company Name:

Contact Name:

Fax #:

Email:

Company Address:

Title:

City:

Province

Postal Code:

Comments:

2 | Company Name:

Contact Name:

Fax #:

Email:

Company Address:

Title:

City:

Province

Postal Code:

Comments:

BANKING INFORMATION

Bank Name:

Contact Name:

Bank Address:

Bank Phone:

City:

Province

Postal Code:

Type of Account:

Account Number:

Office Partitions

Glass Railing Services

Glass Shower Doors

Glass Shower Door Styles

Shop Closet Organizers

Top Quality Railings

Shop Mirrors

Alpha Glass Other Services

Shop Glass Products

Contractor Registration Form