Become A Dealer Form

Please use this form when applying for credit. Fill out requested information. It is imperative that you complete the credit application and include valid references and fax numbers. Incomplete information or lack of information can prolong the approval time and could result in denial of credit. Credit verification can take up to four weeks depending on how quickly your references respond to us. In order for the application to be complete, you must check all boxes and sign and date where indicated. We will review the credit application once we have received all references and bank information. Upon review of information we have received, we will mail your company a letter stating the results of the credit application.*

Yes, I agree.

Mailing Address

Company Name*

Date/Time*

Address*

Address Line 1

City

State

ZIP Code

Phone*

Fax

Email*

Business Information

Check One*

Corporation Partnership Individual

Years In Business*

Number of Employees*

Principal's Name*

Principal's Phone*

Principal's Address *

Address Line 1

City

State

ZIP Code

Business References (List accounts with whom you have had for more than one year)

Business Reference #1*

Business Reference #2*

Business Reference #3*

Banking Information

Bank Name*

Address*

Address Line 1

City

State

ZIP Code

Phone*

Fax

Email*

Account #*

Date Received:*

References Checked By*

Credit Limit*

Credit Approved By*

Date Approved*

Letter Mailed*

I certify that all information on this application is correct. I personally assume full responsibility for all charges made to my company’s account. I personally guarantee the full performance of the firm, whether a corporation, partnership, or otherwise, of all debts and obligations to GlassCraft Door Corporation, and agree to pay within the terms. I understand that if legal proceedings become necessary to collect monies owed, all court cost, legal fees and attorney fees, an interest of 18% per annum will be added to the amount owed GlassCraft Door Corporation, and will be paid by our firm, and I agree that the venue of these legal proceedings shall be Houston, Harris County, Texas. In addition, I authorize the above firms to release to Glass Craft Door Corporation any information required for the establishment of credit.*

Yes, I agree.

Signature*

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Use your mouse or finger to draw your signature above

Title*