Individual Credit Account Application for Shepley Wood Products

Fill out our Online Form below to apply for an Individual Credit Account. (printable PDF)

Date of Application

Amount of Credit
Requested

Name

Current Address

If PO Box, give
street and house #

Social Security #

Home Telephone #

Work Telephone #

Cell Phone #

Fax #

E-Mail Address

Name and address
of employer

# of years with
employer

Title/Position

Have you done
business under
another name?
If so, give name
and address

Firms with whom
you have had an
open account

[Firm Name and Address]

Bank References

[Please state branch and contact]

Supplies to be
used for

	Construction of own house		Remodeling
	Construction of spec/custom house(s)		Household projects

How did you
hear about us?

	Referral		From one of our salespeople
	Advertising

Best description
of business