Open An Account

Company name:

Business type:

Address:

City:

Province:

Postal code:

Phone number:

Fax number:

Billing address / accounts payable same as above

YesNo

Department to indicate on invoice:

Accounts payable contact’s name:

Phone number:

Extension:

Email address:

Contact persons - Business person in charge

Last Name:

First name:

Phone:

Extension:

Cell phone:

Email:

Shipping personnel name(s)

Name:

Phone:

Extension:

Email address:

Business hours and access

Days and Hours of Operation

Accessible at lunch time for drivers between noon and 1 pm
YesNo

Other details on accessibility

Note and/or additional comments

Note: