Credit Application - Select Delivery Systems

The first step in making use of our delivery services is to apply for a free account with Select Delivery Systems Inc.

To apply, please fill in the online credit application below. Alternatively, you may print an application by clicking HERE, fill it in and fax it back to us.

Application for Credit
Your email address*
Enter Email Confirm Email
Business Name*
Address*
Street Address Address Line 2 City Province Postal Code
Telephone Number (including area code)*
Fax Number (including area code)
How Did You Hear About Select Delivery Systems?
Billing Address (if different than above)
- Check if same as above
Address*
Street Address Address Line 2 City Province Postal Code
Telephone Number (including area code)*
Fax Number (including area code)
Company Officer or Accounts Payable Contact
Name*
First Last
Title*
Telephone Number (including area code)*
Fax Number (including area code)
Terms of Credit
All accounts are due when rendered. Interest @ 2% monthly will be charged on all invoices which are more than 30 days in arrears. Payments are to be made to head office.
Name (Applicant)*
First Last
Telephone Number (including area code)*
Date*
MM slash DD slash YYYY
By submitting this form, I agree that all of the above information is accurate. The submission of this form will act as my handwritten signature.
Phone
This field is for validation purposes and should be left unchanged.

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Application for Credit

Billing Address (if different than above)

Company Officer or Accounts Payable Contact

Terms of Credit