Account Qualification Form

    Company Name:*

    Address:

    City:

    Province:

    Postal Code:

    Phone Number:*

    Email:

    Fax:

    PST#:

    Owner’s name:

    Years in business:

    Is your business a residence
    yesno

    Is your business incorporated :
    yesno

    Three Trade References:




    Comments

    Contact Details

    Address:
    7832 Venture Street
    Burnaby BC V5A 1V3

    Phone: 604 415 9500
    Fax: 604 415 5454
    Toll Free: 866 415 9505
    Email: info@planetpress.ca