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Credit Application

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Credit Application

Pursuant to section 26 of the Freedom of Information and Protection of Privacy Act (the Act), the personal information collected will only be used for the purposes of evaluating your application. Your personal information will not be released except in accordance with the Act.

Questions about the collection of your personal information may be referred to the Cariboo Regional District’s Deputy Corporate Officer/Executive Assistant, Suite D, 180 North Third Avenue, Williams Lake, BC, V2G 2A4, 250-392-3351 or mailbox@cariboord.ca.

Name of company:

Check one of the following:

Corporation

Partnership

Proprietorship

Year established:

Phone:

Fax:

Email:

Mailing address:

Accounts payable contact name:

Credit amount requested:

REFERENCES

Company name:

Contact name:

Address:

Phone:

Fax:

Email:

Company name:

Contact name:

Address:

Phone:

Fax:

Email:

Company name:

Contact name:

Address:

Phone:

Fax:

Email:

I hereby certify that the information provided is correct and true.

I understand that the terms are net 15 days.

I authorize the Cariboo Regional District to obtain any credit information which can be made available.

Date:

Signature:

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Credit Application

REFERENCES