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Business Name:
*Contact Name:
*Address:
Address 2:
*City:
*Province:
*Postal Code:
*Phone Number:
*Fax Number:
*Company Email:
PST#:
GST#:

What type of business do you operate?
 
How long have you been in the above business?
 
Are you a member of a promotional product/advertising specialty organization?
 
How did you find out about us?
 

Trade References (imprintables / promotional)

Contact Name: Phone:
Company Name: Fax:
Address: How Long Have You Been Buying from this Company?
< 1 year
1 - 5 Years
6 - 10 Years
> 10 years

Contact Name: Phone:
Company Name: Fax:
Address: How Long Have You Been Buying from this Company?
< 1 year
1 - 5 Years
6 - 10 Years
> 10 years

Contact Name: Phone:
Company Name: Fax:
Address: How Long Have You Been Buying from this Company?
< 1 year
1 - 5 Years
6 - 10 Years
> 10 years

Contact Name: Phone:
Company Name: Fax:
Address: How Long Have You Been Buying from this Company?
< 1 year
1 - 5 Years
6 - 10 Years
> 10 years

Additional Comments:
 
*Indicates a required field.
 

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