Become A Customer - ST Fasteners

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Become A Customeradmin2023-10-09T13:26:15+00:00

New Customer Application

Click Here to download the credit application form.

Company Or Individual Name *

Billing Address *

Shipping Address *

Phone Number *

Phone 2 / Fax

Email Address *

Are your purchases subject to sales tax? If no, please attach a resales or exemption certificate` *

Yes

Upload here

Choose File

Type of Business *

Proprietorship

Partnership

Corporation

Date Established

Principal's Address *

Principal's Phone Number *

Bank Information

Bank Reference *

Contact *

Address *

Phone Number *

Trade References

Name *

Phone Number *

Phone 2 / Fax *

Email *

Name *

Phone Number *

Phone 2 / Fax *

Email *

Name *

Phone Number *

Phone 2 / Fax *

Email *

Company Information

Person responsible for purchasing fasteners *

Email Address *

Person responsible for accounts payable *

Email Address *

We buy fasteners for: *

Manufacturing or production

Maintenance

Resale

Constructor

Other

How would you like to receive your invoices? *

Mail

Fax

Please check all categories that apply:

Do you ever have requirements for customer/special hardware items?

Where did you hear about our company?

What is your estimated monthly fastener usage (in US dollars)?

I understand that all information provided herein is for the purpose of obtaining credit and that such information will be handled in confidence. I further understand that this and all supplemental financial and credit information supplied are a part of this application and that any false or misleading information shall constitute a fraudulent misrepresentation.

Signature (type your name) *

Today's Date *

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First Name *

Last Name *

Business Name

Phone Number

Email Address *

Select Industry *

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