GREENHOUSES & FARM MARKET
130 OLD DENVILLE RD BOONTON TWP, NJ 07005
PHONE (973) 334-6528 *FAX (973) 299-9424
Credit Application
| Company.Name_________________________________________________________________ |
| DBA________________________________________________________________________ |
| Billing Address _______________________________________________________________ |
| City ________________________ State ________ Zip ___________________ |
| Phone ___________________________ Fax ____________________ |
Credit Information
Please list the name, address and phone number of three vendors
where you currently purchase plants and related items on account.
Vendor Name _________________________________________________________________
Address ______________________________________________________________________
Phone _____________________________ Fax _______________________________________
Vendor Name _________________________________________________________________
Address ______________________________________________________________________
Phone _____________________________ Fax _______________________________________
Vendor Name _________________________________________________________________
Address ______________________________________________________________________
Phone _____________________________ Fax _______________________________________
------------------------------- Office Use Only -------------------------------
Remarkes:___________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Credit Approved? __________ Amount ____________________$5000 or more requires corporate approval |