Two Technologies Credit ApplicationTo apply for credit, please print the form below and fax it back to |
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APPLICATION FOR CREDIT Date: ___/___/___ Firm Name: __________________________________________________________ Proprietor or Partners Name: ____________________________________________ Address: ___________________________________________________________ ____________________________________________________________________ Phone Number: ( ) ______________ Fax Number: ( ) ________________ TRADE REFERENCES - Open Account Only Name Address Telephone # 1.__________________________________________________________________ 2.__________________________________________________________________ 3.__________________________________________________________________ BANK REFERENCES Name Address Telephone # 1.__________________________________________________________________ 2.__________________________________________________________________ Dun & Bradstreet Number ______________________ I understand that Two Technologies terms are 2% 10 days Net 30 days. Signature ___________________________________________________________ Title _______________________________________________________________ |
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