Customer Application

* Marks a mandatory field

* Applicant/Company Name

Other

* Principals

* PST#

* Year Established

* Mailing Address

* Shipping Address

* Multiple location billing

* Phone

* General Email

* Estimated Monthly Purchases (C$)

Credit Limit Desired (C$)

* President/CEO/Owner

* Phone

EXT #

* Email

* Purchasing

Receiving

Quality Assurance

* Trade Reference Company 1

* Contact Name

* Phone #

* Email

* Trade Reference Company 2

* Trade Reference Company 3

* Check here to indicate you have read and agree to the Fasteners and Fittings Terms and Conditions