Please fill out this form and the Credit References form. 
We will contact you after we have reviewed your application.

Take me to the Credit References form.

Company Information:
Company Name:
Street Address:
City: State Zipcode
Phone Number:		Fax Number:
Accounts Payable Contact:		Phone Number:
Name of Principal Owner:		Years in Business:
By submitting this application online, the herein applies for credit in accordance with terms and conditions of Polypak Plastics.  Our terms are 1% 10, net 30.
Finance Information:
Bank:
Bank Address:
City: State Zipcode
Phone Number:		Fax Number:
Bank Contact:		Phone Number:
We certify that the information contained in the form is correct.  We fully understand the PolyPak Plastics credit terms and agree to the payment schedule in accordance with your credit terms.
Date:		Signed:
		Title: