For any questions about the form, please contact mblanchard@deschenes.ca

Company Information
Owner and / or shareholders
President
Vice-President
Purchasing Manager
Account Payable Manager
Type of industry/commerce
$
Banking Information
Credit Request
$
$
Involvement in bankruptcy or insolvency?
Credit Reference
Other Information
Which email address do you want to receive your invoices to?
Client member of the C.M.M.T.Q?
Back orders accepted?
Order number required?
Signature of Commitment (By an authorized person on the company’s bank account.)
I

Certify that the information mentioned above is true. I am requesting the opening of an account with Deschênes & Fils and I understand that a web account will also be created. I agree to respect the terms of sale and terms of payment. I authorize Deschênes & Fils to obtain the information necessary for the evaluation of my request and to exchange it if necessary. I understand that the creation of the account will automatically add my email address to Deschênes & Fils' list of communications, but that I will have the opportunity to unsubscribe. I understand that my full name acts as an official signature.

I certify that I have read and accepted the terms of sale and payment