ACCOUNT APPLICATION

Please complete this form if you are opening a new account. This is not a credit application. Terms and conditions will be determined based on business type and volume.

TODAY'S DATE

YYYY

COMPANY INFORMATION

BUSINESS TYPE

Please select one.

LEGAL COMPANY NAME

BILLING ADDRESS

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

COMPANY PHONE

(###)

###

####

COMPANY EMAIL ADDRESS

ACCOUNTING INFORMATION

ACCOUNTING CONTACT

First Name

Last Name

ACCOUNTING PHONE NUMBER

(###)

###

####

ACCOUNTING EMAIL

INDICATE PREFERRED METHOD OF PAYMENT

CHEQUE

CREDIT CARD

EFT WIRE TRANSFER

INTERACT e-TRANSFER

TAX EXEMPTION

PST # (for resale clients only)

CERTIFICATE OF INDIAN STATUS or SCIS #

AUTHORIZED PURCHASERS

PURCHASER #1

First Name

Last Name

Phone

(###)

###

####

PURCHASER #2

First Name

Last Name

Phone

(###)

###

####

PURCHASER #3

First Name

Last Name

Phone

(###)

###

####

PURCHASER #4

First Name

Last Name

Phone

(###)

###

####

FORM COMPLETED BY

NAME OF PERSON COMPLETING THIS FORM

First Name

Last Name

DISCLAIMER

We will retain this information for accounting purposes only. This information will not be shared outside of Spectra Event Group.

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