Credit Application

Contact Information:

Company Name  

Your Name
Address City
State Zip
Phone Fax
Contact Email Billing Email (leave blank if same)

Business Information:

Type of business
 

Years in business
Hours of operation
Closed for lunch
P.O. or Reference # required?

Principals (officers, partners or owners)

Principal 1 (Include position)
Principal 2 (Include position)

Trade References ( give only those you buy from an open account)

Name Account #
Address Phone
Name Account #
Address Phone

FREE Technology Options:

Yes! I want Email notice when a new order is entered.
Yes! I want Email confirmations when my order has been picked up.
Yes! I want Email delivery confirmations

Yes! I want to receive invoices via Email (Sent to billing email)
TERMS: 

IT IS MUTUALLY AGREED THAT ALL GOODS ARE ACCEPTED IN GOOD ORDER (EXCEPT AS NOTED). IT IS FURTHER AGREED THAT THE LIABILITY OF AFFORDABLE COURIER SOLUTIONS, INC. IS LIMITED TO A MAXIMUM OF $100 PER SHIPMENT. ANY AND ALL CLAIMS ARE WAIVED IF NOT SUBMITTED IN WRITING TO OUR OFFICE WITHIN THIRTY (30) DAYS OF DELIVERY. WAIT TIME FREE UP TO 5 MINUTES. $1.00 PER MINUTE WAIT AFTER 5. $.05 PER POUND WILL BE CHARGED FOR SHIPMENT WEIGHTS OVER 50 POUNDS.

By submitting this form you are agreeing to the above terms.

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