Your Name:
Business Name:
Address:
City:
Province:
Postal Code:
Country:
Telephone #:
Fax #:
Email Address:
Business Type:	Retail Store   Installer Commercial Other
If Other, Please Specify:
Number of years in business:
Ontario Businesses - Are you PST Exempt?	Yes No
If Yes, enter Vendor Permit Number:
Request for a credit account: (A separate Credit Application   must be completed and approved)	Yes No
Preferred Method of Payment: (Terms are C.O.D. until a separate   Credit Application has been approved)	Company Cheque Wire    Visa MasterCard Cash
Comments or Questions: