We are the proud recipient of the 2008 Bess Cohn Memorial Humanitarian Award
This award is presented to an individual who embraces the giving, loving and selfless nature that embodied Bess Cohn's many acts of kindness.

Corporate Account Application

* indicates required fields

Bill To:		Ship To: (If different than Bill To)
* Firm Name:		Firm Name:
Street Address:		Street Address:
City:		City:
State:		shipState:
Zip:		Zip:
* Individual:		Individual:
Phone:		Phone:
Fax:		Fax:
* Email:		Email:

Credit Information (must be filled out for all new accounts):
A.	Customer Tax Exempt No Yes
B.	Customer is a Corporation Partnership Individual
C.	Business location is Owned Rented
	No. of employees
D.	How long has customer been in business
	How long at present address?
E.	If this is a branch office or subsidairy, give location of headquarters or indicate name of parent organization.

F.	Customer's Bank
G.	Customer buys from the following concerns on an open account basis: (please provide phone and fax numbers)
	1.
	2.
	3.
	4.

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Adirondack Ad Specialties :: Imprinted Business & Advertising Gifts :: ADK Promos

Corporate Account Application

Bill To:

Ship To: (If different than Bill To)

Credit Information (must be filled out for all new accounts):