Credit Application Form
Please use this form to apply for a new account with Crystal Lake Manufacturing, Inc.  You will receive an E-mail after submission with details of your account.  Follow-up by regular mail or phone may be necessary. Note: Orders will be cash in advance until credit is approved.
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 Enter Your Company Information

Company Name:

Company Phone:
Street Address: Mailing Address:
City, State Zip: City, State Zip:
Your Name: Best Time to Call:
Your E-Mail Address: Your Phone:
Your Phone: Your Position/Title:

Enter Trade Reference Information:

First Reference

Name:    Address: 

Account Number:      Point of Contact:

Phone Number: (xxx) xxx-xxxx

Second Reference

Name:   Address:

Account Number:     Point of Contact:

Phone Number: (xxx) xxx-xxxx

Third Reference

Name:    Address:

Account Number:     Point of Contact: 

Phone Number:  (xxx) xxx-xxxx

Bank Reference

Bank Name:    Address:

Account Number:    Point of Contact:

Phone Number:    (xxx) xxx-xxxx