Credit Application

About This Form

We appreciate your interest in partnering with us for your metal removal needs.

Once your application is submitted, our team will review it promptly and notify you of the decision within a few business days. We look forward to fostering a strong and successful partnership with you.

To upload a pre-filled application, click here.

"*" indicates required fields

Customer Information

Company Name*

DBA

Business Type

Year Established

Federal Tax ID#

Desired Credit Limit

UPS/FEDEX Account #

Is a purchase order required?

Yes

Billing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Shipping Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

AP Contact

AP Contact*

First Last

Phone*

Fax

Email*

Purchasing Manager

Purchasing Manager*

First Last

Phone*

Fax

Email*

Authorized Purchasers

It is your responsibility to keep this list up to date.

Authiorized Purchasers*

Use (+) or (-) to add or remove authorized purchasers.

First Name

Last Name

Credit References

Ref #1 Name*

Ref #1 Email*

Ref #1 Account #*

Ref #2 Name*

Ref #2 Email*

Ref #2 Account #*

Ref #3 Name*

Ref #3 Email*

Ref #3 Account #*

Terms & Conditions

Submitter Name*

First Last

Title

Referred by

How did you hear about us?

Other:

Sales Representative

Name

This field is for validation purposes and should be left unchanged.

Credit Application

About This Form

Customer Information

AP Contact

Purchasing Manager

Authorized Purchasers

Credit References

Terms & Conditions

Referred by

Connect

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