Schroeder Log Home Supply, Inc.
SLHS Wholesale Customer Information Form

As of January 1st, 2007 new credit accounts are available to wholesale customers purchasing $3,000.00 or more annually. To request a Credit Application, include a note in the Comments Section below.

**PRIVACY ASSURANCE: We only use the details below for our company's internal purposes. We will not pass your Personal Information to marketing companies or any other 3rd party companies.

Fields marked with * are required.

*Date
*Company Name
Billing Address:

*Address Line
*City
*State
*Zip Code

*Phone
Shipping Address: (if different from Billing Address)
Address Line
City
State
Zip Code

E-Mail
Cell
Fax
   Website

*Organization Type (Corporation, Partnership, or Sole Proprietor)
Personnel:



*Owner/Manager
Sales Manager
Secretary
Accounts Payable

Other


*Key Officers and/or Owners

*Number of Employees

*Number of Locations

*Number of Years in Business


*
Federal ID No. or SS Number
Exempt Number
Contractor's License Number


*Log Contruction? *General Contruction?

* Main Products/Services offered by your Company:


Names & Phone numbers of three businesses that know you as a contractor:
* 1. Phone
* 2. Phone
* 3. Phone

Comments