Account Application

Please fill out the below credit application form to apply for an account with Surface Exteriors.
This form is also available as a PDF download which can be emailed to metal@surfaceexteriors.com.

    FIRST NAME *
    LAST NAME *

    COMPANY NAME

    EMAIL ADDRESS *
    PHONE NUMBER *

    FULL ADDRESS including POSTAL CODE *

    INCORPORATION #
    GST #
    BUSINESS STRUCTURE *
    TYPE OF BUSINESS *
    P.O.s REQUIRED * YESNO
    PST EXEMPT * YESNO

    DIRECTOR #1

    FIRST NAME *
    LAST NAME *
    SIN # *
    BIRTH DATE *

    FULL ADDRESS including POSTAL CODE *

    DIRECTOR #2 (fill out only if applicable)

    FIRST NAME
    LAST NAME
    SIN #
    BIRTH DATE

    FULL ADDRESS including POSTAL CODE

    BANK REFERENCE

    BANK NAME *
    BANK MANAGER

    BANK ADDRESS *

    ACCT TRANSIT # *
    ACCT # *

    COMMENTS

    AUTHORIZED SIGNATURE

    FULL NAME *
    POSITION *

    TERMS & CONDITIONS

    The Applicant hereby applies for an account with Surface Exteriors Ltd (the “Supplier”) regarding the supply by the Supplier to the Applicant of services and/or materials (the “Credit Account”). All invoices are due and payable upon receipt of ordered goods. The applicant will make payment to the Supplier for the invoice amount of all materials services supplied by the Supplier via authorized credit card information provided on page 2 of this application. The undersigned acknowledges and agrees that by providing their credit card information within this application, they authorize the Supplier to obtain monies due on their account. please note all credit card numbers provided are strictly confidential to the establishment and maintenance of any and all credit extended by the supplier.