Credit Card Application

Credit Card Account Application

Please Complete the Application Below

Required files are listed in * RED. Do NOT use AUTOFILL or AUTOCOMPLETE as that may interfere with the sending of your form.

Have you been in contact with an APD sales representative?

* Legal Name of Business

* Contact First Name

* Contact Last Name

* Street Address

Address Line 2

* City

* Province/State

* Postal/ZIP Code

* Email Address

* Phone

Fax

* I consent to receive the APD Newsletter by Email

Yes

Type of Business:

Partnership

Proprietorship

* # of Employees

* # of Service Bays

Company Web Site

* Anticipated Annual Sales Volume

PST Number

* GST Number

Operating Trade Name

Purchase Order Required?

Accounts Payable Contact Info

* Accounts Payable Contact

* Accounts Payable Email

* Accounts Payable Phone

TERMS and CONDITIONS In consideration of APD (Automotive Parts Distributors), a division of Exhaust Masters Inc., By clicking SUBMIT hereby unconditionally gives authorization to APD, to process all orders by Credit Card. The undersigned also unconditionally authorizes prompt and full payment to APD for all amounts due, relating to any Credit Card orders, by way of the Credit Card.

Thank you for your consideration, APD personnel will reply shortly to obtain credit card information.