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| Free List & Directory Of Canadian Retail Jewellers, If Your Jewellery Store Is Not Listed In Our Directory, Please Contact Us | |
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ACCOUNT APPLICATION, PLEASE PRINT OUT THIS PAGE AND FAX BACK TO US 416-759-9439 COMPANY NAME _________________________________________________________________________________________ TRADE NAME IF DIFFERENT _______________________________________________________________________________ ADDRESS _______________________________________________________________________________________________ CITY _____________________________ PROVINCE ______________________________ POSTAL CODE ________________ TELEPHONE ____________________________ FAX _____________________________ EMAIL _________________________ TYPE OF ORGANIZATION ______________________________________ YEARS IN BUSINESS ________________________ NAMES & TITLES OF PRINCIPAL OWNERS __________________________________________________________________ ________________________________________________________________________________________________________ ANNUAL JEWELRY PURCHASE AMOUNT__________________________ LISTED IN CJA ____________________________ BANK REFERENCE, PLEASE INCLUDE NAME OF BANK, FULL ADDRESS, TEL. #, FAX #, THE NAME BANK OFFICER & BANK ACCOUNT # ______________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ 4 TRADE REFERENCE, PLEASE INCLUDE NAME OF COMPANY, FULL ADDRESS, TEL. #, FAX #, & SALES REP. NAME __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ GST # __________________________________ PST # _________________________DATE ______________________________ SIGNATURE _____________________________NAME _____________________________________ TITLE __________________ |