CARC
4100 Sen. J. Bennett Johnston Avenue
Lake Charles, LA 70615
(337)-433-4235
FAX (337)439-1886

 

CREDIT APPLICATION

(Print this application and mail or fax to the above address or fax number)

NAME:             ___________________________________________________________

ADDRESS:       ___________________________________________________________

                        ___________________________________________________________

TELEPHONE: ___________________________________________________________

FAX:                 ___________________________________________________________





BILLING ADDRESS: ___________________________________________________________

___________________________________________________________



CONTACT PERSON: ___________________________________________________________

TELEPHONE: ___________________________________________________________



Do you require a purchase order? ___________________________



Our terms are net 30 days.

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