Marino Credit Application @ MarinoMop.com

Credit Application:

Please use this "On-Line" form to apply for a new account with S. Marino Manufacturing Ltd. You will receive confirmation after submission with details of your account. Follow-up by regular mail or phone may be necessary. Note: Orders will be cash in advance until credit is approved.

For versions of this form suitable for submission by mail or fax, click on the icons to the right.

open the credit application on a separate page for printing

open a PDF version of the credit application

open a Microsoft Word version of the credit application

Company Information:

Company Name:
Company Phone:	(xxx) xxx-xxxx
Company Fax:	(xxx) xxx-xxxx
Street Address:
City, Prov:
Postal Code:

Mailing Address:
City, Prov:
Postal Code:

Your Name:
Position/Title:
Your Phone:	(xxx) xxx-xxxx
Best Time to Call:
E-Mail Address:

Federal ID / Sales Tax #:
GST # (Canada Only):

Trade Reference Information:

First Reference

Name:
Address:
City, Prov:
Postal Code:
Account Number:
Point of Contact:
Phone Number:	(xxx) xxx-xxxx
Fax Number:	(xxx) xxx-xxxx

Second Reference

Name:
Address:
City, Prov:
Postal Code:
Account Number:
Point of Contact:
Phone Number:	(xxx) xxx-xxxx
Fax Number:	(xxx) xxx-xxxx

Third Reference

Name:
Address:
City, Prov:
Postal Code:
Account Number:
Point of Contact:
Phone Number:	(xxx) xxx-xxxx
Fax Number:	(xxx) xxx-xxxx

Bank Reference Information:

Bank Name:
Address:
City, Prov:
Postal Code:
Account Number:
Point of Contact:
Phone Number:	(xxx) xxx-xxxx
Fax Number:	(xxx) xxx-xxxx


Thank you!

	©2001, S. Marino Manufacturing Ltd.
	2545907 customers served