Welcome to NAIL1

Credit Request Form:
Company Name:
Billing Address:
City:	State: Zip Code:
Ship to Address:
City:	State: Zip Code:
Telephone Number:
Fax Number:
E-Mail Address:

Please Give a List of Three Current Venders:
VENDOR 1
Company Name:
Street Address:
City:	State: Zip Code:
Telephone Number:
VENDOR 2
Company Name:
Street Address:
City:	State: Zip Code:
Telephone Number:
VENDOR 3
Company Name:
Street Address:
City:	State: Zip Code:
Telephone Number:

Other Information
Type of Company:	Corporation: Sole Proprietorship: Partnership:

If Corporation Please Give Accounts Payable Contact:

If Sole Proprietorship Please Give Owners' Name:

If Partnership Please Give Partners' Name:
Partner 1
Partner 2

Are Purchase Order Numbers Required? YES NO
.
Please List the Names of Those Who Are Allowed to Place Orders:

Any Other Comments Please Put Here:


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