COMPANY INFORMATION Company: Sales Contact: Accounting Contact: Address: Country,State/Prov,City: Telephone1: Fax: Telephone2: E-mail: Home Page (URL): Check one:     Partnership     Corporation     Propriertorship Year Established: Sales Tax ID No: Yearly sales: I. OWNERS/PRINCIPLES Name: Name: Soc.Sec.#: Soc.Sec.#: Address: Address: City,State,Zip: City,State,Zip: Telephone: Telephone: II. TRADE REFERENCES/CUT FLOWERS SUPPLIERS 1. Company Name: Telephone: Contact: FAX: 2. Company Name: Telephone: Contact: FAX: 3. Company Name: Telephone: Contact: FAX: III. BANK REFERENCE Bank Name: Address: City,State,Zip: Officer: Account No: Telephone: FAX: SHIPPING INFORMATION Shipping Method: Agency Address Telephone Shipping Address: Country State/Province City Address Zip PAYMENT INFORMATION Line of Credit : Credit Days: LOGIN INFORMATION Login: Password: Retype Pass: Question: Answer:     Copyright 2002 Flortec Flowers Powered by StarNetSys