Credit Application

FJC Credit Application

If you would like to apply for credit with FJC, please complete and submit our credit application with a minimum of three (3) references required.

Additionally, our credit application is available in the following formats for your convenience.

Printable

PDF Credit Application

Editable

Xcel Spreadsheet Application

Thank you for your interest in FJC. We are committed to providing you with great products and excellent customer service.

If you would like to apply for credit with FJC, please complete our online credit application below.

Alternatively, you can submit your completed credit application via mail, fax, or email.

Mail

101 Commercial Drive, Mooresville, NC 28115

Fax Number

704-664-5522

admin@fjcinc.com

Company Name *

Your Name *

Email Address *

Years in Business *

Resale Tax # (cert must also be attached) *

Attach resale tax certificate. *

Affiliated with (dba)

Bill to Address *

Ship to Address *

PRINCIPAL PARTNERS

Principal Partner Name *

Phone Number *

Email Address *

Principal Partner Name

Phone Number

Email Address

ADDITIONAL STAFF NAMES

Additional Staff Name

Phone Number

Email Address

Additional Staff Name

Phone Number

Email Address

Additional Staff Name

Phone Number

Email Address

Additional Staff Name

Phone Number

Email Address

REFERENCES

NOTES: Must have three (3) credit references

Supplier *

Address *

Fax Number *

Phone Number *

Email Address *

Account Number *

Contact Name *

Supplier *

Address *

Fax Number *

Phone Number *

Email Address *

Account Number *

Contact Name *

Supplier *

Address *

Fax Number *

Phone Number *

Email Address *

Account Number *

Contact Name *

Supplier

Address

Fax Number

Phone Number

Email Address

Account Number

Contact Name

We certify that all information on this form is correct. We fully understand your credit terms and agree to the proper payment.

Date *

Authorized Digital Signature (Officer of Company) *

Name and Title *

I consent to allow FJC to store and process the personal information submitted above to provide you the information requested.*

* required field

Credit Application