Application must be completed and signed to initiate processing.
Do you or parent have an existing acct. #: YesNo
If yes, please provide acct. #: YesNo
Are Vouchers Required for Payment YesNo If yes, please submit with orders.
STATE SALES TAX EXEMPT: YesNo
Name AND TELEPHONE OF PERSON RESPONSIBLE FOR ACCOUNTS PAYABLE:
SHIPPING: Complete OnlyPartial Shipment OkayAre PO's RequiredYesNo
The following persons are authorized to purchase from this account:
REFERENCES (MAJOR SUPPLIERS)
This information is warranted to be true and is given for the purpose of obtaining credit from High Tech Connections (we) agree to pay all bills for purchases net 30 days from the date of invoice. Should legal action be instituted to enforce payment of any outstanding balance, I (we) agree to pay all costs of suit and reasonable attorney's fees.
Please email the : completed form to: hightechconnections@usa.net or Fax to: 614-920-0854
Payment Remittance Address : High Tech Connections Post Office Box 910 Pickerington OH 43110 (USA)
For Internal Use Only
