New Customer Sign Up

Legal Name
Trade/Operating Name
Mailing Address
Street Address
City/Town
Province
Postal Code
Telephone
Fax
Shipping Address (if different than above):
Street
City/Town
Postal Code
Telephone
Fax
Proprietorship
- Proprietorship
Partnership
- Partnership
gf_right_third
- Limited Company
Date Business Opened
Date Format: MM slash DD slash YYYY
Type of Business
GST#
PST#
(Please enclose exemption certificate of above)
Owners/Partners/Principal Information (attach a separate list if necessary)
Name
Title
Street Address
City/Town
Province
Postal Code
Telephone
S.I.N #
Mortagagee/Landlord Name
Address
Telephone
Date Lease Expires
Name of Bank
Branch #
Address
Telephone
Have you ever been involved in a Receivership or Bankruptcy?
Bankruptcy?
- Yes
- No
If yes when?
Is a Current Financial Statement Available?
Financial Statement?
- Yes
- No
Annual Sales $
Credit Amount Requested $
Contact for Orders
Payment
If you are part of a buying group or association please supply the following
Name
Telephone
Member#
Credit references (suppliers who are granting credit terms): (Name, Telephone and Fax)

Credit references

Name	Phone	Fax

Reason for Application
Reason for application
- New Business
- New Customer
- New Ownership
- Name Change
Other
I/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 Signature
Application Date (M/D/Y)
MM
DD
YYYY
Please Note: All orders will be shipped on a C.O.D. basis until credit terms can be established. (note: this may take several orders)

Shipping Address (if different than above):