The ExpressWay^TM: Your fastest connection to products and services in Horticulture^SM

Item Class

1. ORGANIZATION & ACCOUNT INFORMATION 2. GUARANTEE, TERMS AND CONDITIONS 3. CREDIT & TRADE REFERENCES 4. REGISTRATION

Confidential Credit Application

Please complete the Credit Application carefully. Any application not filled out completely will not be considered. Typically, it may take four to six weeks for credit approval depending on the cooperation of your credit references.

Date *

NAME AND ADDRESS INFORMATION

Legal Name of Business *

First Name *

Last Name *

Email *

Shipping Address

Line 1 *

Line 2

City *

Country *

State *

Postal Code *

Phone Number *

Fax Number *

Billing Address

Same as Shipping

Line 1 *

Line 2

City *

Country *

State *

Postal Code *

Phone Number *

Fax Number *

ORGANIZATION INFORMATION

Organization Type *

Annual Sales Volume *

Number of Acres in Production *

Have You ever Declared Bankruptcy?

Have you ever done business under another name?

Have you ever had credit with us or purchased from us before?

OWNERS, PARTNERS, OFFICERS AND/OR STOCKHOLDERS INFORMATION

Please enter a minimum of one (maximum of two)

Contact 1

Name *

Address *

City *

State *

Postal Code *

Add a new Contact

Phone Number *

Email *

Current Position *

Contact 2

Name

Address

City

State

Postal Code

Remove Contact

Phone Number

Current Position

ACCOUNT INFORMATION

Amount Of Credit Desired *

Account's Payable Phone Number *

Account's Payable Contact *

Account's Payable Email *