Application for Credit

If you have not ordered from us before, please fill in & remit back.

Fax: 403-793-8641                 E-mail:  brideinbloom@telus.net

Address: 32 Park Place, Brooks, Alberta, T1R 1G6

 COMPANY NAME: __________________________________________________________________________

 ADDRESS: __________________________________________________________________________________

 CITY, PROV. & CODE ________________________________________________________________________

 TEL.________________________________________________________________________________________

 G.S.T. TAX NO. _________________________ PROV. TAX NO. ______________________________________

 AUTHORIZED SIGNATURES: __________________________________________________________________

 LENGTH OF TIME IN BUSINESS: _______________________________________________________________

 NAME OF BANK: ___________________________ TEL. ____________________________________________

 ESTABLISHED SUPPLIERS:

1.____________________________________________________________________________________________

2.____________________________________________________________________________________________

3. ____________________________________________________________________________________________

Agreement with Bride in Bloom

In consideration of purchasing goods on credit:

1. We will pay within 30 days of the billing date the amount shown on statement. 

2. We acknowledge the right to assess our firm a service charge of 24% per annum (2% per month) on any balance over 30 days past due and we agree to pay said service charge.

3.I consent to a credit investigation.

DATE ______________________________, 20____________

AUTHORIZATION APPLICANT’S SIGNATURE FOR

NAME OF COMPANY: __________________________________________________________________________

SIGNATURE: ___________________________________________________________________________________