Step 1 of 250%Legal NameTrade/Operating NameMailing AddressStreet AddressCity/TownProvincePostal CodeTelephoneFaxShipping Address (if different than above):StreetCity/TownPostal CodeTelephoneFaxProprietorship ProprietorshipPartnership Partnershipgf_right_third Limited CompanyDate Business Opened Type of BusinessGST#PST#(Please enclose exemption certificate of above)Owners/Partners/Principal Information (attach a separate list if necessary)NameTitleStreet AddressCity/TownProvincePostal CodeTelephoneS.I.N #Mortagagee/Landlord NameAddressTelephoneDate Lease ExpiresName of BankBranch #AddressTelephoneHave you ever been involved in a Receivership or Bankruptcy?Bankruptcy?YesNoIf yes when?Is a Current Financial Statement Available?Financial Statement?YesNoAnnual Sales $Credit Amount Requested $Contact for OrdersPaymentIf you are part of a buying group or association please supply the followingNameTelephoneMember#Credit references (suppliers who are granting credit terms): (Name, Telephone and Fax)Credit referencesNamePhoneFax Reason for ApplicationReason for application New Business New Customer New Ownership Name ChangeOtherI/we hereby authorize Tree of Life Canada ULC. to proceed with, now and when required; whatever credit investigations (consumer and commercial) considered necessary to establish and maintain a credit account. I/we also agree, if a credit account is granted, to pay all invoices within terms of sales; to pay interest charges of 2% per month on any overdue balances; and that credit privileges may be revoked at Tree of Life Canada ULC's discretion.Authorized Customer SignatureApplication Date (M/D/Y) MM DD YYYYPlease Note: All orders will be shipped on a C.O.D. basis until credit terms can be established. (note: this may take several orders) NameDate AddressContact InformationPhoneEmail* Minimum Order Requirement for delivery: For Food Service, Fresh, Natural & Organic, International and Specialty & Gourmet products an order must reach a combined total of $750 A separate order must be placed for all frozen brands totalling $500PLEASE ANSWER THE FOLLOWING:How did you hear about Tree of Life?Are you a Foodservice Account i.e. Hotel or Restaurant?YesNoIf Yes do you have a retail outlet?YesNoOnline business - please provide your website address Are you a pharmaceutical account?YesNoAre you a gift basket account?YesNoAre you a Wholesaler?YesNoDo you have multiple locations?YesNoDo you have a warehouse location?YesNoDo you operate out of your home?YesNoDo you require a delivery appointment?YesNoWhat type of products are you looking for?CommentsThis field is for validation purposes and should be left unchanged.