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Buyers Guide, Martinsburg, WV

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Fill out the Credit Application below.
Or you may download our interactive PDF Credit Application, fill it out and mail or fax back to us.

CUSTOMER INFORMATION (Confidential)

Your Name:  

Your E-mail:  

Business Name:  

Business Address:  

Billing Address:  

City, State, Zip:  

Phone (with area code):  

Type of Business:  

Date Started:  

Now Trading As:  
(select one):  

If Proprietorship, Owner's Name:  

Home Address:  

Home Phone (with area code):  

If Partnership, Partner's Name(s):  

Home Address(es):  

Home Phone(s) (with area code):  

If Corporation, Officer's Name/Contact Person:  

Home Address:  

Home Phone (with area code):  

List Advertising Media You Have Accounts With (If none, please list suppliers)
Name account is in, address, phone and account number

1:  

2:  

 

3:  

 

Bank Name:  

Bank Address:  

Bank Phone:  

Account #:  

Name on Account:  

Bank Officer for Account:  






Questions or comments?
E-mail to brian@yourbg.com or Call 304-267-9983
©2008 Panhandle Buyers Guide. All Rights Reserved.
Buyers Guide
415 Wilson Street
Martinsburg, WV 25401
304-267-9983
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