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Credit application

Please provide the following information to apply for credit terms

Company name:
Street address:
Mailing address:
City, State, Zip:
Phone:
Fax:
Email address:
Website:
Applicationfilled out by:
Title:

Tax Exemption Certificate sent via:	Fax (fax to 208 939-0461) Email (email here) None
Type of business:
Credit amount requested:	$

Trade References: (All references must have complete name, address, phone, fax number & email address)

Reference 1

Name:
Address:
City, State, Zip:
Phone:
Fax:
Email address:

Reference 2

Name:
Address:
City, State, Zip:
Phone:
Fax:
Email address:

Reference 3

Name:
Address:
City, State, Zip:
Phone:
Fax:
Email address:

Bank Reference

Bank:
Address:
City, State, Zip:
Phone:
Fax:
Account number:


		ounces
		drams
		milliliters
		liters
		pints
		quarts
		gallons

Please note that all bottles have different overflow capacities (e.g. an 8 oz bottle may actually hold 8.5 oz). If exact capacity is necessary, please request a sample.


		inches
		centimeters
		millimeters

Type:
Style:
Color:
Material:
Neck finish:
Lid Size:
Liner:
Volume:	to

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Length:	to inches
Width:	to inches
Height:	to inches
Diameter:	to inches