Credit Application

HomeCredit Application

Business Information

Name of Business *

Billing Address *

City *

Province *

Postal Code *

Shipping Address *

City *

Province *

Postal Code *

Telephone *

Email Address *

Year of Business *

Type of Business *

Preferred Language *

Ownership Information

Proprietorship *

Partnership *

Limited Company *

Name of proprietor or directors of company *

Credit Limit Requested *

Accounts Payable Manager *

GST Exempt *

Billing Funds*

Banking References

Banking Institution *

Branch Address *

Telephone *

Credit References

Reference 1 - Name *

Email Address *

Telephone *

Reference 2 - Name *

Email Address *

Telephone *

Reference 3 - Name *

Email Address *

Telephone *

E-mailed Invoices

Would you prefer to receive invoices by e-mail? *

If yes, e-mail address *

Acceptance of Terms

Terms: It is hereby agreed that invoices are to be paid on a net 30 days basis. All overdue accounts are subject to a 2% interest charge per month (24% / year)

Name of Applicant *

Title *

Email Address of Applicant : *