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	Credit Application

MY BLUEPRINTER
1450 AIRPORT RD. NO., STE B
NAPLES, FL 34104
239 262-7400FAX: 239 262-8230
Email: info@myblueprinter.net

CUSTOMER CREDIT APPLICATION

Company Name:
Address:
City:	State: Zip:
Bus. Phone:	Bus. Fax:
Email Address:
Accts. Payable Contact:

OWNERSHIP INFORMATION:

President/Owner:
Address:
City:	State: Zip:

TRADE REFERENCES:

Name:	Phone:
Address:	Fax:
City:	State: Zip:

Name:	Phone:
Address:	Fax:
City:	State: Zip:

Name:	Phone:
Address:	Fax:
City:	State: Zip:

I, the undersigned, agree to pay within the specified credit terms of net 15 days should credit be extended to me or my company. I further agree to be directly responsible for payment of all invoices charged to my account within this designated time period. By clicking "SUBMIT" you agree that all of the information you have provided in this form is true