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CREDIT APPLICATION
COMPANY NAME
BILLING ADDRESS
STREET
CITY
POSTAL CODE
TELEPHONE
FAX
SHIPPING ADDRESS
STREET
CITY
POSTAL CODE
TELEPHONE
FAX
ACCOUNTS PAYABLE SUPERVISOR
E-MAIL ADDRESS
PROVINCIAL SALES TAX #
BANK
BRANCH
CONTACT
TELEPHONE
TRADE REFERENCES
1. COMPANY
TELEPHONE
FAX
2. COMPANY
TELEPHONE
FAX
3. COMPANY
TELEPHONE
FAX
ESTIMATED CREDIT REQUIRED $
TEL.
(905) 564-9777
COPYRIGHT 2008 HEARTLAND SHIPPING SUPPLIES INC.
DESIGN & HOSTING BY ONECORE MEDIA
TOLL FREE
1-800-668-8773
FAX.
(905) 564-2240
E-MAIL:
order@heartlandshippingsupplies.com
