Bryan China Company
657 Northgate Circle
New Castle, Pennsylvania 16105
Ph 800-966-3098   Fax 724-658-8968

ONLINE CREDIT APPLICATION
(You can either submit this form online or print it out and fax or mail)

Contact Name
 Your Title
Company Name
 Business Name, if different
Select One :       Years in Business
What type of Food Service Organization are you?  
Annual Sales Volume
Billing Address   
Shipping Address
Phone Fax  Email 

Trade References:

Company Name     Address
Phone      Account Opened Since      High Credit

Company Name     Address
Phone      Account Opened Since      High Credit

Company Name     Address
Phone      Account Opened Since      High Credit

Banking Reference:
Institution Name     Contact Name   
Address     Phone     Account #
Account Opened Since        Account Type

Institution Name     Contact Name   
Address     Phone     Account #
Account Opened Since        Account Type

I hereby certify that the information contained herein is complete and accurate. This information has been furnished with the understanding that it is to be used to determine the amount and conditions of credit extended. Furthermore, I hereby authorize the financial institutions listed in this credit application to release necessary information to the company for which credit is being applied for in order to verify the information contained herein.


Name
Date

                      To Send Online                           

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