New Customer Form

Business Information

Business name must be between 3 and 70 characters. No special characters please.
Please select your CTS sales rep.
Please add the business contact's name.
Please add the business contact's title.
Please add the business contact's phone number.
Please add the business contact's email.
Website
http://
Please select the amount of years the company has been in business.
Business Address

*Is the Business Address outside the United States?

Please enter the address of the business.
Please provide a City.
Please provide a valid State or Province.
Please select a valid Country.
Please provide a valid Zip Code.
characters remaining

Accounts Payable

Please enter the name of your accounts payable conact person.
Please provide a phone number for your accounts payable conact person.
Please provide an email address for your accounts payable conact person.
Accounts Payable Address

*Is the AP Address outside the United States?

Please provide a valid Billing Address.
Please provide a city.
Please provide a valid State or Province.
Please select a valid country.
Please provide a valid zip code.

Bank Information

Please add the Bank name.

*Is the Bank Address outside the United States?

Please provide the Bank address.
Please provide a City.
Please provide a valid State or Province.
Please select a valid Country.
Please provide a valid Zip Code.
Please add the contact persons name.
Please add the contact persons title.
Please add the contact persons phone number.
Please add the contact persons email.
Please add the depository account information.
*Trade Reference Info (PDF or Word only)
Upload

Tax Exempt Status

If you select "Yes" you will need to upload a Sales Tax Exempt Certificate in PDF or Word format.

Agreement

By clicking on this checkbox you, the Applicant, hereby authorize CTS Cement Manufacturing Corporation (CTS) to obtain from applicant or third parties such information as CTS may require in connection with its application for credit. Applicant certifies that the information contained in the Application and all financial information is true and correct, and acknowledges that CTS will rely on such information for extending credit. Applicant acknowledges that he/she has read, and agrees that Buyer will be bound by the CTS Terms and Conditions of Sales. Prior to the acceptance of orders for the Product, and at any time and from time to time thereafter upon demand from Seller, Buyer shall provide Seller such credit information as may be reasonably required by Seller to determine Buyer’s financial creditworthiness.

For more information review the CTS Cement Manufacturing Corporation Sales and Credit Terms and Conditions Agreement.

Credit will not be extended until all information is verified.

Please sign your name.
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