Cart - Facility Direct

Customer Information

Business Name(Required)

Name of Business

Business Phone(Required)

Business Email Address(Required)

Enter Email Confirm Email

Address(Required)

Street Address Address Line 2 City State ZIP Code

Requested Credit Limit

What is your expected monthly spend with Facility Direct?

(Anticipated monthly spend)(Required)

$100 - $1,000

$1,000 - $5,000

$5,000 - $10,000

$10,000 - $50,000

$50,000 - $100,000

$100,000 - $500,000

Owner or Management Information

Reporting Structure(Required)

Business Structure(Required)

Total Properties Owned/Managed(Required)

Years in Business(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Purchasing Contacts

1st Contact Name(Required)

First Last

Company Title

Phone

2nd Contact Name

First Last

Company Title

Phone

3rd Contact Name

First Last

Company Title

Phone

Invoice Delivery

How would you like to recieve your invoices?

Send Invoices VIA(Required)

Other

Business Email Address(Required)

Enter Email Confirm Email

Upload Attachments

Upload attachments to help us process and approve your application.

Tax Exempt Document

Upload your tax exemption in .pdf, .doc or .docx format

Accepted file types: pdf, doc, docx, Max. file size: 100 MB.

Credit Sheet

Upload your credit sheet in .pdf, .doc or .docx format

Accepted file types: pdf, doc, docx, Max. file size: 100 MB.

Other 1

Upload other documents to help us process in .pdf, .doc or .docx format

Accepted file types: pdf, doc, docx, Max. file size: 100 MB.

Other 2

Upload other documents to help us process in .pdf, .doc or .docx format

Accepted file types: pdf, doc, docx, Max. file size: 100 MB.

Your Cart

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Email Address

Phone Number

Products

Company

Contractors

User

Customer Information

Requested Credit Limit

Owner or Management Information

Purchasing Contacts

Invoice Delivery

Upload Attachments

Your Cart

Step 1/3

Step 2/3

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Net30 Application

Customer Information

Requested Credit Limit

Owner or Management Information

Purchasing Contacts

Invoice Delivery

Upload Attachments