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* Required Field

Company Information

Federal Tax ID # (US Only):
or GST # (Canada Only):
*Legal Name of Firm/Company:
DBA (if applicable):
Shipping Address (line 1):
Shipping Address (line 2):
Shipping City:
Shipping Province/State:
Shipping Postal/Zip Code:

Please Provide Billing Address Information

*Billing Address (line 1):
Billing Address (line 2):
*Billing City:
*Billing Province/State:
*Billing Postal/Zip Code:
Type of Business:

Years in Business:
Trade References (two required):
Reference 1:
Company Name:
Reference 2:
Company Name:

Contact Information

*Primary Contact Name (person requesting account):
*Primary Contact Phone:
Primary Contact E-Mail:
Primary Contact Fax:
Secondary Contact Name:
Secondary Contact Phone:
Secondary Contact E-Mail:
Secondary Contact Fax:

Accounts Payable Billing Information

*Accts. Payable Contact Name:
*Accts. Payable Phone:
Accts. Payable E-Mail:
Accts. Payable FAX:

Shipment Information

Anticipated monthly account volume:
Anticipated # of shipments per month:
Items being shipped:
Current same day shipping provider:
Current small parcel shipping provider:
Primary Shipping Location:
Other Shipping Locations: (list up to 19 or ALL if more than 19):
Will you need pick-up and /or delivery?

Would you like someone to contact you to discuss our online shipping application?

Terms NET THIRTY DAYS from the date of invoice. A finance charge of 1.5% per month will be added to past due accounts.

Please note that by pressing the "Submit Application" button you are acknowledging and accepting all terms outlined and implied by the Greyhound Package Express and Greyhound Package Express electronic credit application form as well as consenting for the use of your personal information in the credit application process. By submitting this application, you are authorizing the Corporation to proceed with credit investigation as required.