Credit Application

To apply for credit with Cotswold Industries, please fill out and submit the form below. Please be as complete as possible with your information. Should you have any questions, please call F.W. McKinnon at 212-689-3432. Once you have submitted the application, you will be notified by email as to your status.

Items marked with * must be completed.

Step 1 of 2 -

Company Information:
Company Name*
Billing Address1
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Phone*
Fax*
Email*
We will contact you by email, please double check your address.
Duns#
Year Incorporated
Number of Employees
Ship to Information:
Name
Address
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Phone
References Bank:
Name
Address
Street AddressCityState / Province / RegionZip / Postal CodeCountry
Telephone
Contact Name

Trade:
Name
Address
Street AddressCityState / Province / RegionZip / Postal CodeCountry
Phone
Contact Name
Trade:
Name
Address
Street AddressCityState / Province / RegionZip / Postal CodeCountry
Phone
Contact Name
Trade:
Name
Address
Street AddressCityState / Province / RegionZip / Postal CodeCountry
Phone
Contact Name
By completing this form and entering my name below, I am giving Cotswold Industries, Inc. and its agents permission to contact any and all of the above for information as regards this credit application.
Persons's name completing the form*
Position

Credit Application

Credit Application

Step 1 of 2 -

Company Information:

Ship to Information:

References Bank:

Trade:

Trade:

Trade:

Suppliers To: