Solarlift - New Account Application

Solarlift Online Account Application

Please complete the form and press the submit button.

Business Name:

Date:

Address:

City:

Province:

Postal Code:

Name of Applicant:

Phone:

Ext:

Fax:

Email Address:

Type of Business:

Years of Operation:

How did you hear about Solarlift?

Bank Name:

Contact Name:

Telephone:

Ext.:

Business Type: Sole Proprietor Partnership Corporation

Premises owned or rented?: Owned Rented

Num Employees:

Amount Requested:

A/P Contact:

Ext.:

Maintenance Contact:

Ext.:

President Name:
Gen/Operations Manager Name:

Do you issue purchase orders?	Yes No
Purchase Mgr:

Notes and Special Requests:

Authorization/Terms of acceptance

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