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First Name:
Middle Name:
Last Name:
Email:
Username:
Password:
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Information about your company:
Company Name:
Address 1:
Address 2:
City:
State/Province:
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Country:
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Website:
Please tell us whatever you'd like us to know about your company:
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Credit Application: Like many manufacturers, VDC generally does business with its distributors on a Net 30 basis. This is not a requirement, but if you would like to be granted this level of financial trust, please fill out the following Credit Application. None of the fields below are required, but the more information you can give us, the easier it will be to validate credit terms. If you are not comfortable with providing this information in an online form, please contact us and we will be happy to send you a standard credit reference application form. Partnership:
Names of partners (Separate by commas):
Corporation:
Name of President:
Name of Buyer:
Banking Information:
Name of Bank:
Address 1:
Address 2:
City:
State/Province:
Postal Code:
Country:
Phone:
Fax:
Primary Contact Name:
Contact Email:
Loan Officer Name:
Loan Officer Email:
Account Number(s) (Separate by commas):
Trade References: If possible, please include at least two references from manufacturers or distributors who supply you with goods for resale at credit level equal to or exceeding what you are expecting from Vogel Display Corp. First Trade Reference:
Company Name:
Address 1:
Address 2:
City:
State/Province:
Postal Code:
Country:
Primary Contact:
Contact Email:
Phone:
Fax:
Website:
Second Trade Reference:
Company Name:
Address 1:
Address 2:
City:
State/Province:
Postal Code:
Country:
Primary Contact:
Contact Email:
Phone:
Fax:
Website:
Third Trade Reference:
Company Name:
Address 1:
Address 2:
City:
State/Province:
Postal Code:
Country:
Primary Contact:
Contact Email:
Phone:
Fax:
Website:
Validation: I HEREBY AUTHORIZE VOGEL DISPLAY CORPORATION TO CONTACT THE ABOVE LISTED REFERENCES AS WELL AS THE NECESSARY CREDIT REPORTING AGENCIES FOR THE PURPOSE OF INVESTIGATING MY CREDIT IN ORDER TO ESTABLISH AN ACCOUNT IN MY NAME ON THEIR BOOKS. IF LEGAL ACTION SHOULD EVER BECOME NECESSARY TO EFFECT COLLECTION OF MY ACCOUNT, I AGREE TO PAY COURT COSTS AND ATTORNEY FEES IN CONNECTION HEREWITH. By signing your full name in the space below, you agree to the terms and conditions specified in the paragraph above.
Signature:
Date Signed:

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