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Credit Application

Please complete the Credit Application if you are applying for a GHC Products, Inc. Account


    Legal Name (required)

    Contact Name (required)

    Contact email (required)

    Physical Address (required)

    Mailing Address (if different)

    Telephone (required)

    Fax Number

    Business Type (required)

    Description of Business (required)

    Resale Number

    Resale License Copy

    Bank References

    Bank Name (required)

    Bank Address (required)

    Bank Contact Name (required)

    Bank Contact Telephone Number (required)

    Trade References

    Supplier 1

    Supplier (required)

    Supplier Address (required)

    Supplier Telephone (required)

    Supplier Fax Number (required)

    Supplier Contact Name (required)

    Supplier Credit Limit (required)

    Supplier 2

    Supplier 2 (required)

    Supplier 2 Address (required)

    Supplier 2 Telephone (required)

    Supplier 2 Fax Number (required)

    Supplier 2 Contact Name (required)

    Supplier 2 Credit Limit (required)

    Supplier 3

    Supplier 3 (required)

    Supplier 3 Address (required)

    Supplier 3 Telephone (required)

    Supplier 3 Fax Number (required)

    Supplier 3 Contact Name (required)

    Supplier 3 Credit Limit (required)