<%@LANGUAGE="VBSCRIPT" CODEPAGE="65001"%> Zanda Panda Wholesale Credit Application

ZANDA PANDA Specialty Bakeware
Wholesale Application
Application for Credit

FAX TO 860-828-3336

Or mail to: ZANDA PANDA, ATTN: WHSLAPP, PO Box 7332, Kensington, CT 06037

Terms: Net 30, FOB Berlin, CT
For complete terms, please visit: http://www.zandapanda.com/terms.asp

Please fill out the information below to create an account:
Company Information   Billing Information
Company Name:
  ____________________________________________
First Name:
  ____________________________________________
Last Name:
  ____________________________________________
Address 1:
  ____________________________________________
Address 2:
  ____________________________________________
City:
  ____________________________________________
State:
  ____________________________________________
Zip/Postal Code:
  ____________________________________________
Phone Number:
  ____________________________________________
Fax:
  ____________________________________________
Email:
  ____________________________________________
    Shipping Information (if different from above)
Company Name:
  ____________________________________________
First Name:
  ____________________________________________
Last Name:
  ____________________________________________
Address 1:
  ____________________________________________
Address 2:
  ____________________________________________
City:
  ____________________________________________
State:
  ____________________________________________
Zip/Postal Code:
  ____________________________________________
   
Type of Ownership:
  ____________________________________________
Federal ID#:
  ____________________________________________
State ID#:
  ____________________________________________
   
Owner of Officers:
  ____________________________________________
Date Ownership Established:
  ____________________________________________
Type of Business:
 
□ Retailer (One Location)
□ Retailer (Chain)
□ Museum Shop
□ Craft/Hobby Store
□ Online Retailer
□ Catalog Retailer
□ Show/Fair Retailer
□ Craft Producer
□ Distributor
□ Independent Rep
□ Rep Group
□ Retail Customer
□ Other
Bank Reference    
Bank Name:
  ____________________________________________
Address:
  ____________________________________________
City:
  ____________________________________________
State:
  ____________________________________________
Zip/Postal Code:
  ____________________________________________
Contact Person:
  ____________________________________________
Phone:
  ____________________________________________
Email:
  ____________________________________________
Account #:
  ____________________________________________
Please supply five Trade References:    
Company 1:
  ____________________________________________
Address:
  ____________________________________________
  ____________________________________________
Contact Person:
  ____________________________________________
Phone:
  ____________________________________________
Fax:
  ____________________________________________
Email:
  ____________________________________________
Account #:
  ____________________________________________
     
Company 2:
  ____________________________________________
Address:
  ____________________________________________
  ____________________________________________
Contact Person:
  ____________________________________________
Phone:
  ____________________________________________
Fax:
  ____________________________________________
Email:
  ____________________________________________
Account #:
  ____________________________________________
     
Company 3:
  ____________________________________________
Address:
  ____________________________________________
  ____________________________________________
Contact Person:
  ____________________________________________
Phone:
  ____________________________________________
Fax:
  ____________________________________________
Email:
  ____________________________________________
Account #:
  ____________________________________________
     
Company 4:
  ____________________________________________
Address:
  ____________________________________________
  ____________________________________________
Contact Person:
  ____________________________________________
Phone:
  ____________________________________________
Fax:
  ____________________________________________
Email:
  ____________________________________________
Account #:
  ____________________________________________
     
Company 5:
  ____________________________________________
Address:
  ____________________________________________
  ____________________________________________
Contact Person:
  ____________________________________________
Phone:
  ____________________________________________
Fax:
  ____________________________________________
Email:
  ____________________________________________
Account #:
  ____________________________________________

 

Credit Card Information

  Newly established businesses with less than five trade
references, please fill in the information below:

Card Type:
  □ MasterCard     □Visa     □ AmEx     □ Discover
Credit Card #:
  ____________________________________________
Expiration Date:
  ________________/_______________(MM/YY)
CCV Code:
  ____________________________________________
   

Please note: your credit card will be not be charged unless your payment becomes 60 days past due. You will then be charged the full amount of your order. A late charge of 1.5% will also be applied.

By completing and sending this form you are agreeing to ZANDA PANDA Specialty Bakeware's terms and conditions.


Please fax printed application to 860-828-3336 or mail to:

ZANDA PANDA Specialty Bakeware
ATTN: WHSLAPP
PO Box 7332
Kensington, CT 06037

ZANDA PANDA Specialty Bakeware PO Box 7332, Kensington, CT 06037 860-828-3336