Date Est.
Email:
Default Contact Information
Contact First Name:
Contact Phone:
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Contact Email:
Accounts Payable Contact Information
AP Contact First:
AP Contact Last:
AP Contact Phone:
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Business Type (check all of the following that apply)
Products Used (check all of the following that apply)
I Want to use a COD basis (please choose one)
COD Type:
COD (Certified Funds)
COD Company Check
Check By Phone
Bank:
Location:
Acct. Num:
Bank Phone:
Bank Contact:
I Want to use Credit Card (avoids COD fees)
After submitting the form, please contact us toll free at 1-800-733-3316 to supply your CC details.
Authorization to release information (must agree to terms)
All of the information herin is correct to my best of knowledge. I authorize any business or person named herein to furnish information concering my affairs to Restyler's Choice LLC. Restyler's Choice LLC's trade terms include interest on past due accounts at the maximum legal rate. I have read, understand and agree to the attached terms and conditions. By choosing credit card terms, I authorize Restyler's Choice LLC to charge my card above for purchases of goods and services placed by phone, fax, internet or email.
