Credit Application
Credit Application
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Billing Information
If No, please enter your Shipping Information below
Are you listed in Dun & Bradstreet?*
Reference Information
BANK Reference
BUSINESS Reference
PO Required*
Send scanned copy of CFC to or TEXT it to 316-263-8179
Are you Tax Exempt?*

If you answered Yes to Tax Exempt, and your business is reselling, please print and fill out the below PDF Tax Form. Email it back to or mail it to PO BOX 3268 Wichita KS 67201. If you have a different tax form (ie. project exemption, school) please send that form instead.

Exemption Certificate Blank.pdf

Would you like to be set up with Online Shopper?
Your Email will be your Shopper ID. Password set up will be sent to your email. 
Would you like to receive our seasonal sales flyers?

By submitting this application you certify that you have the authority to submit this information and request credit for this company. If approved, the Standard Terms are NET10th. Accounts with a past due balance will be charged a service charge of 1.5% (18% Annum) on the past due amount. You agree to pay all invoices within the terms specified.