New England Wholesale Florist
Customer Application

Store Information
Company Name: 
Owner Name:
Street/Billing Address: 
Company Phone: 
Fax: 
Tax Resale Number: 
Email Address: 

Credit References
Company Name: 
Years Associated: 

Company Name: 
Years Associated: 

Company Name: 
Years Associated: 

Owner's Info
Name (print or type): 
Home Address: 
City/State/Zip:  
Drivers License #: 

Owner's Personal Guarantee
For and in consideration of New England Wholesale Florist, Extending credit at the undersigned's request. (herein after referred to as "Company"), the undersigned (whether one or more) jointly, severally and unconditionally personally guarantees the full and punctual payment when due of all indebtedness now or here after owing by said Company. This guarantee additionally binds the undersigned to pay any attorney's fees and/or court costs assessed by a court, or paid by New England Wholesale Florist Corp. should account be placed with the attorney for collection.

Owner's Signature:                                                         Owner's Name:

_________________________________________________________________________________ 
								           (Please Print)
Date:

          __________________

        Fax this form completed to (203) 630-0777 or email it to Office@NewEnglandFlorist.com 
           If sent thru email - this application must be signed in person upon your 1’st order.
                      Important: We also need a photocopy of your state Sales Tax ID form.
THIS IS NOT A CREDIT APPLICATION.  ALL NEW ACCOUNTS ARE C.O.D.  -  NO EXCEPTIONS.