Become A Dealer Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Legal Business Name: *Name: *Ship to Address: *City: *State: *Zip: *Please specify which days are available for deliveries: *MondayTuesdayWednesdayThursdayFridaySaturdaySundayPlease specify delivery hours: *Mailing Address: *City: *State: *Zip: *Phone: *Fax:Accounts Payables Email: *EmailConfirm EmailHow Long in Business:Person to contact about Account:Business Type: *C CorporationS CorporationLLCPresident/Member: *SS#: *Vice President/Member: *SS#: *Secretary/Member: *SS#: *Your Bank's Name: *Branch: *Phone: *Address: *City: *State: *Zip: *Officer Contact: *Account Number: *Type of Account: *CheckingSavingsReference #1 Contact Name: *Business Name: *Address: *Phone: *Email: *Reference #2 Contact Name: *Business Name: *Address: *Phone: *Email: *Reference #3 Contact Name: *Business Name: *Address: *Phone: *Email: *On behalf of the above named company/business, I/we authorize Cobblestone Mill Woodworks, Inc. to run any necessary credit reports and/or contact my trade references for credit ratings. I also authorize the release of any bank information to Cobblestone Mill woodworks, Inc. Upon approval of credit, the undersigned agrees to Cobblestone Mill Woodworks, Inc. Terms and Conditions of Sale. If, in the event of default of said Terms and Conditions of Sales, the party at fault will be liable for any collection fees, court costs and/or attorney’s fees that may result from such default. *Yes, I agreeYour Name: *Title: *Today's Date: *Submit
