Fill out this form to open an account. You can also print this form and send it by fax at 514-933-5037

ACCOUNT INFORMATION

Legal Name
Trade Name
Street Address
 City
Postal Code
Province
Owner & Buyer
Store Hours
Telephone Number
Fax Number
Email
Shipping address if different from above


IF MORE THAN ONE STORE, PLEASE LIST EACH

Street Address
City
 Province
Street Address
 City
 Province
Street Address
 City
 Province
Type of ownership (Individual/Partnership/Corporation/Branch)


CREDIT REFERENCE

Company
 Contact Person
Phone Number
Company
 Contact Person
Phone Number
Company
 Contact Person
Phone Number


BANK REFERENCE

Bank
 Contact Person
Street Address
   City
Province
   Postal Code
Bank Phone Number
  Bank Fax Number
Bank Account Number
GST Number
PST Number


STORE INFORMATION
Annual Store Sales
Square Feet of Retail Store
Number of Full Time Employees
Number of Years under Current Ownership
Year Business Started
Number of Years at this Location
Expected Annual Purchase
 Credit Requested