Credit Application

  To apply for credit with Cotswold Industries, please fill out and submit the form below. Please be as complete as possible with your information. Should you have any questions, please call F.W. McKinnon at 212-689-3432. Once you have submitted the application, you will be notified by email as to your status.

Items marked with * must be completed.

Company Information:
Company Name *:  
Billing Address 1 *:  
Billing Address 2:  
City *:  
State *:   Zip or Postal code
Country:  
Telephone *:   Fax:
Email *:  
 We will contact you by email, please double check your address.
Duns #:  
Year Incorporated:     Number of Employees:
 
Ship to Information:
Name:  
Address 1:  
Address 2:  
City:  
State:   Zip or Postal code
Country:  
Telephone:   Fax:
Email:  

References
Bank:
Name:  
Address:  
City:  
State:   Zip or Postal code Country:
Telephone:  
Contact Name:  
 
Trade:
Name:  
Address:  
City:  
State:   Zip or Postal code Country:
Telephone:  
Contact Name:  
 
Trade:
Name:  
Address:  
City:  
State:   Zipor Postal code Country:
Telephone:  
Contact Name:  
 
Trade:
Name:  
Address:  
City:  
State:   Zip or Postal code Country:
Telephone:  
Contact Name:  

By completing this form and entering my name below, I am giving Cotswold Industries, Inc. and its agents permission to contact any and all of the above for information as regards this credit application.
Person's name completing the form *:
  Position*

 

For Questions, contact F.W. McKinnon at 212-689-3432