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Business

* Company Name Trade Name
* Prinicipal Name Affiliated Companies
Billing Address
* Billing City                * Billing Province / State                * Billing Postal Code / Zip     
* Shipping City            * Shipping Province / State           * Shipping Postal Code / Zip
Telephone Fax
Toll Free Toll Free Fax
Email Website
Main e-mail address Sales & Marketing News email address
PPPC #                                   ASI #                                    Others
Type of business                  Years in business                Number of Employees      
Type of Company  
Accounts Payable Contact Phone / Ext.
Accounts Payable Email
Principal

Name             Home #            Cell #           
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City              Province / States             Postal Code / Zip            
Credit Card

Checking here authorizes Martini Promotions to charge your credit card

Credit Card Holder's Name
Credit Card #
 master card  visa
Expiration
Month :      Year :  
Banking

Name of Financial Institution
Bank Address
 City                                      Province                            PostalCode
Telephone                                                 Bank Account #
       
Bank Contact                         Tel #                                 Fax #     
Trade References

Supplier reference information
Supplier Name Type of Industry
Contact Name                        Tel #                                 Fax #      
Supplier Name Type of Industry
Contact Name                        Tel #                                 Fax #      
Terms and conditions (Credit Policy)

I / WE ACCEPT AND CONSENT TO THE OBTAINING OF INFORMATION FROM ANY CREDIT REPORTING AGENCY, OR FINANCIAL INSTITUTION, AND CONSENT TO THE DISCLOSURE OF ANY INFORMATION CONCERNING THE UNDERSIGNED TO ANY CREDIT REPORTING AGENCY. ALL INFORMATION ON THIS CREDIT APPLICATION IS WARRANTED TO BE TRUE. PRIOR TO CREDIT APPROVAL, ALL ORDERS WILL BE EITHER CERTIFIED CHEQUE, C.O.D., OR CREDIT CARD. IMPRINTED ORDERS WILL BE SUBJECT TO A DEPOSIT OR PAYMENT IN ADVANCE BEFORE PROCEEDING WITH PRODUCTION. ANY NSF CHEQUES RECEIVED WILL RESULT IN CREDIT TERMS BEING REVOKED AND EVALUATED, ALONG WITH A $35.00 ADMINISTRATION FEE. IF THE ACCOUNT BECOMES DELINQUENT AND PLACED INTO COLLECTION, THE DELINQUENT PARTY IS RESPONSIBLE FOR ANY COLLECTION FEES INCURRED. CREDIT TERMS AND LINES ARE REVIEWED ON A CONTINUAL BASIS AND ARE ADJUSTED ACCORDING TO YOUR SALES AND PAYMENT PERFORMANCE. THE APPLICANT AGREES TO ALL THE TERMS AND CONDITIONS AS PUBLISHED ON OUR WEB SITE AND PRINTED IN OUR CATALOGUES WITH JURISDICTION GOVERNED BY THE LAWS OF CANADA AND THE LAWS OF THE PROVINCE OF QUEBEC WITHOUT REGARD TO CONFLICTS OF LAWS. I / WE AGREE TO KEEP WITHIN TERMS IF GRANTED CREDIT, AND UNDERSTAND THAT NEW OR PENDING ORDERS MAY BE HELD IF MY ACCOUNT BECOMES DELINQUENT.

* BY TYPING YOUR NAME HERE YOU AGREE TO OUR TERMS AND CONDITIONS
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