Accounts

New Account Application

Company Information
Company Name: Yrs in Business:
Business Phone: Home Phone:
Fax: E-mail Address:
President: Secretary:
       
  Shipping Address   Mailing Address
Street & Unit #: Street & Unit #:
City/Town: City/Town:
Province/State: Province/State:
Postal/Zip Code: Postal/Zip:


Bank Reference
Bank Name: Branch Address:
Account Type: Account #:
Phone: Fax:
Contact Name:    


Supplier References
  Reference #1 Reference #2 Reference #3
Company:
Address:
Phone:
Fax:

By submitting this application to us, you agree to authorize Canadian Vinyls Inc. or its agent to conduct any credit checks it deems necessary in order to extend credit to the named company and/or individuals.