WTD Supply offers Net 30 Day payment terms to qualified customers. To establish an Open Account with these payment terms please provide the information requested below. This process usually takes just one business day, depending upon the quickness of a response from your references. Our credit manager or one of our Customer Care representatives will contact you as soon as we have reviewed the responses from your references.

*Please fill out completely. Missing and/or inaccurate information will delay processing.
**We assure you that all information provided herein will be kept confidential, and will be used solely for the purposes of establishing an Open Account line of credit with WTD Supply.

Trade Reference 1
Company name:
Street address:
City:
State:
Zip code:
Phone number:
Fax number:
Contact name:
Trade Reference 2
Company name:
Street address:
City:
State:
Zip code:
Phone number:
Fax number:
Contact name:
Trade Reference 3
Company name:
Street address:
City:
State:
Zip code:
Phone number:
Fax number:
Contact name:

Bank Account Information
Bank name:
Street address:
City:
State:
Zip code:
Phone number:
Fax number:
Bank account officer:
Your checking account number:

Please fill in any comments or questions that you may have in the space below: Credit Check Authorization I am the individual or an authorized officer of the organization as stated in "Your company/individual's business name" above, and I have the authority to request that an Open Account be established with WTD Supply. The information I have provided is accurate, correct and current to the best of my knowledge. Typing the word YES in the space below will be accepted as my electronic signature authorizing WTD Supply to check my/our credit references for the purpose of establishing the aforementioned Open Account. Please type YES here to continue