Credit Application
Please fill all fields highlighted below. In references, either email or fax is required.
Primary Applicant
Business Name
Corporation Federal ID
Business Address
City
State
Zip
Telephone
Fax
Email
D&B Number
Year Established
Number of Employees
Estimated Monthly Volume requested for Credit
$
Delivery
Appointments needed
Lift gate truck
Electronic Documents Interchange available (EDI)
Type of Business
Corporation
Partnership
Sole Proprietorship
Other
Other
Nature of Business
Big Box
Drug
Ecommerce
Foodservice
Grocery
Hardware
Healthcare
Hospitality
Jansan
Lumber Hardware
MRO
Office Supply
Packaging
Redistribution
Retail
Safety
Specialty Retail
Representative Information
Sales Rep (Or manually enter below)
Beal, Noel (NOELB) (Strategic Packaging)
Brady, Sean (SMMREP) (Strategic Packaging)
Ciesinski, Mike (WMCMREP) (WMC Associates)
Curio, Madeline (MC) (Aluf Plastics)
Durlacher, Dave (DMMREP) (Durlacher Marketing)
Eichenstein, Rivka (RIVKA) (Aluf Plastics)
Fess, Todd (TFES) (Performance Sales)
Freidland, Brad (BRADF) (Strategic Packaging)
Gans, Mark (GANZ) (Performance Sales)
Guerrera, John (JohnGU) (Aluf Plastics)
Kipke, Nicholaus (NK) (Reps)
Koller, Steve (FAVB) (Favorite Brokers)
Leibert, Eric (ERIC) (Genesis Sales Associates)
Libon, Bob (BOBL) (Aluf)
Membreo, Yamil (EY) (Genesis Sales Associates)
Moore, Ben (BM) (Gilbert)
Repke, John (RWMREP) (Reps)
Repke, John (JR) (Reps)
Rosenberg, Joseph (JOER) (Aluf)
Schulgasser, Matt (MATTSREP) (Aluf)
Schultz, Clifford (CLFS) (Aluf Plastics)
Splain, Chad (CSRSM) (Aluf Plastics)
VanTassel, Laura (LV) (Aluf Plastics)
Wolkein, Ross (TPTMREP) (The Perfect Team)
Manufactures Representative Agency
Mfg Sales Rep Name
Representative Email
Group Membership
None
Afflink
Select Marketing
Network
RDA
Prolink
SSS
United
CDI
Nissco
Unipro
DPA
Frosty Acres
Other:
Owners, Officers, Principals and Members
Owner
Confirmation
Price list
Quotation
Invoice
ASN (advance ship notice)
Marketing
Buyer
Confirmation
Price list
Quotation
Invoice
ASN (advance ship notice)
Marketing
Acct's Payable
Confirmation
Price list
Quotation
Invoice
ASN (advance ship notice)
Marketing
Shipping Manager
Confirmation
Price list
Quotation
Invoice
ASN (advance ship notice)
Marketing
Bank Reference
Bank Name
Phone
Fax
Address
City
State
Zip
Contact
Account #(s)
Trade References
Check this box if you want to open account as COD with no references
Reference 1
Name
Phone
Fax
Email
Address
City
State
Zip
Contact
Type of Products Purchased
Reference 2
Name
Phone
Fax
Email
Address
City
State
Zip
Contact
Type of Products Purchased
Reference 3
Name
Phone
Fax
Email
Address
City
State
Zip
Contact
Type of Products Purchased
By typing in your name manually on this Credit Application , you are signing this application electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement and you authorize Aluf Plastics to contact your noted trade references.
Submit
