Credit Application

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Please enter at least one principal.
Full Name Postal Code

Please provide three business references.
Name of Business Contact Name Full Address Phone

By checking this box and clicking Submit Application below, I agree that the terms of sales are Net 30 days. The amount becomes past due if not paid in full 30 days from date of invoice. I hereby certify that the information contained above is true and correct. I am the applicant named herein or an authorized representative of the corporation named herein.Green Line Hose & Fittings request your permission to contact your bank and references. We are pleased to maintain open credit accounts for customers purchasing $1000 or more annually. For customers with annual hose and fitting requirements of less, we gladly accept MasterCard, Visa, debit, cash, or cheque. We look forward to doing business with you. All information provided on this form will be classified as business information for purposes of handling under privacy legislation.