{"id":56066,"date":"2022-09-13T19:37:06","date_gmt":"2022-09-13T19:37:06","guid":{"rendered":"https:\/\/citypallets.ca\/cpwp\/?page_id=56066"},"modified":"2024-07-02T19:27:50","modified_gmt":"2024-07-02T19:27:50","slug":"customer-form","status":"publish","type":"page","link":"https:\/\/citypallets.ca\/cpwp\/customer-form\/","title":{"rendered":"New Customer Credit Application Form"},"content":{"rendered":"<div class=\"vgblk-rw-wrapper limit-wrapper\">\n\n\t<style>\n    .testing_22 {\n        background-color: #000;\n    }\n    .green-bg-form {\n        background-color: #0d793d;\n        padding:3px; \n        text-align: center; \n        margin-bottom: 10px;\n    }\n    .grey-bg-form {\n        background-color: #dddddd;\n        padding:3px;\n        text-align: center;\n        margin-bottom: 10px;\n    }\n    .signature-pad {outline: #999 1px solid;\n    }    \n<\/style>\n\t<p>Any issues filling out the form? Please get in touch with us at <a href=\"mailto:contact@citypallets.ca\">contact@citypallets.ca<\/a><\/p>\n<p><em>Fields marked with a * are mandatory.<\/em><\/p>\n\t\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f56117-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"56117\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/cpwp\/wp-json\/wp\/v2\/pages\/56066#wpcf7-f56117-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"56117\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f56117-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<!-- SECTION A -->\n<div class=\"green-bg-form\">\n\t<h3 style=\"text-align: center; color: #fff;\">SECTION A: COMPANY INFORMATION\n\t<\/h3>\n<\/div>\n<div class=\"content-column one_half\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Date<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"date-today\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date-today\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<p><label> In Business Since<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"date-businesssince\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date-businesssince\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half\">\n\t<p><label> Type of Business<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-typeofbusiness\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-typeofbusiness\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Corporation, Partnership, Proprietorship or Other (please indicate)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-businessstatus\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-businessstatus\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"content-column one_half\">\n\t<p><label> Legal Name*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-legalname\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-legalname\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Trade Name<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-tradename\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-tradename\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"content-column one_half\">\n\t<p><label> Business Number<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-businessnumber\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-businessnumber\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> If Division\/Subsidiary, Name of Parent Company<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-parentconame\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-parentconame\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"content-column one_half\">\n\t<p><label> Authorized Contact Name*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-contactname\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-contactname\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Authorized Contact Title<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-contacttitle\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-contacttitle\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"content-column one_half\">\n\t<p><label> Authorized Contact Telephone Number*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"tel-contacttelnumber\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"tel-contacttelnumber\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Authorized Contact Email*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"email-contactemail\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email-contactemail\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"content-column one_half\">\n\t<p><label> Company Website<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-companysite\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-companysite\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Head Office Phone Number<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"tel-companynumber\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"tel-companynumber\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<p><label> Head Office Address<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-companyaddress\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-companyaddress\" \/><\/span> <\/label>\n<\/p>\n\n<!-- SECTION B -->\n<div class=\"green-bg-form\">\n\t<h3 style=\"text-align: center; color: #fff;\">SECTION B: DELIVERY INFORMATION\n\t<\/h3>\n<\/div>\n<div class=\"content-column one_half\">\n\t<p><label> Delivery Address*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-deliveraddress\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-deliveraddress\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Purchasing Agent Telephone Number*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-purchaseagenttelnumber\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-purchaseagenttelnumber\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"content-column one_half\">\n\t<p><label> Purchasing Agent Name*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-purchaseagentname\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-purchaseagentname\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Purchasing Agent Email*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-purchaseagentemail\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-purchaseagentemail\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"content-column one_half\">\n\t<p><label> Shipping\/Receiving Hours*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-shippinghours\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-shippinghours\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Additional Comments<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"sectionbcomments\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"sectionbcomments\"><\/textarea><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<p><label> Do you have a dock level door?* <span class=\"wpcf7-form-control-wrap\" data-name=\"dockleveldoor\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"dockleveldoor\"><option value=\"Yes\">Yes<\/option><option value=\"No\">No<\/option><\/select><\/span> <\/label><br \/>\n<label> Do you have a forklift?* <span class=\"wpcf7-form-control-wrap\" data-name=\"forklift\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"forklift\"><option value=\"Yes\">Yes<\/option><option value=\"No\">No<\/option><\/select><\/span> <\/label><br \/>\n<label> Do you have a licensed forklift driver?* <span class=\"wpcf7-form-control-wrap\" data-name=\"licensedforklift\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"licensedforklift\"><option value=\"Yes\">Yes<\/option><option value=\"No\">No<\/option><\/select><\/span> <\/label>\n<\/p>\n\n<!-- SECTION C -->\n<div class=\"green-bg-form\">\n\t<h3 style=\"text-align: center; color: #fff;\">SECTION C: ACCOUNTS PAYABLE INFORMATION\n\t<\/h3>\n<\/div>\n<div class=\"content-column one_half\">\n\t<p><label> Billing Address (if different from above)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-seccaddress\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-seccaddress\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Accounts Payable Contact Name<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-secccontactname\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-secccontactname\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"content-column one_half\">\n\t<p><label> Accounts Payable Email<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-seccemail2\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-seccemail2\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Accounts Payable Telephone Number<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-secctelnumber\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-secctelnumber\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"content-column one_half\">\n\t<p><label> Invoice Email<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-seccinvoiceemail\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-seccinvoiceemail\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Accounts Payable Manager Name<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-seccmanagername\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-seccmanagername\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"content-column one_half\">\n\t<p><label> Accounts Payable Manager Email<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-seccmanageremail\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-seccmanageremail\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Accounts Payable Manager Telephone<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-seccmanagertel\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-seccmanagertel\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<p>&nbsp\n<\/p>\n<!-- SECTION D -->\n<div class=\"green-bg-form\">\n\t<h3 style=\"text-align: center; color: #fff;\">SECTION D: TRADE REFERENCES\n\t<\/h3>\n<\/div>\n<p> Please provide current trade references from companies you have engaged with or purchased from within the last year. The following information is required to establish the payment term. If not provided, all sales are due upon receipt.\n<\/p>\n<h4 style=\"color: #000!important; font-weight: 500;\">REFERENCE 1\n<\/h4>\n<div class=\"content-column one_half\">\n\t<p><label> Company Name*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-referencename1\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-referencename1\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Contact Name<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-referencecomname1\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-referencecomname1\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"content-column one_half\">\n\t<p><label> Company Address<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-referenceaddress1\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-referenceaddress1\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Company Telephone<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-referencetel1\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-referencetel1\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"content-column one_half\">\n\t<p><label> Company Fax<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-referencefax1\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-referencefax1\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Company Email*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-referenceemail1\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-referenceemail1\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<h4 style=\"color: #000!important; font-weight: 500;\">REFERENCE 2\n<\/h4>\n<div class=\"content-column one_half\">\n\t<p><label> Company Name*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-referencename2\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-referencename2\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Contact Name<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-referencecomname2\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-referencecomname2\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"content-column one_half\">\n\t<p><label> Company Address<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-referenceaddress2\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-referenceaddress2\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Company Telephone<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-referencetel2\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-referencetel2\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"content-column one_half\">\n\t<p><label> Company Fax<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-referencefax2\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-referencefax2\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Company Email*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-referenceemail2\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-referenceemail2\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<h4 style=\"color: #000!important; font-weight: 500;\">REFERENCE 3\n<\/h4>\n<div class=\"content-column one_half\">\n\t<p><label> Company Name<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-referencename3\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-referencename3\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Contact Name*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-referencecomname3\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-referencecomname3\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"content-column one_half\">\n\t<p><label> Company Address<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-referenceaddress3\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-referenceaddress3\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Company Telephone<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-referencetel3\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-referencetel3\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"content-column one_half\">\n\t<p><label> Company Fax<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-referencefax3\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-referencefax3\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"content-column one_half last_column\">\n\t<div style=\"padding: 0;\">\n\t\t<p><label> Company Email*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-referenceemail3\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-referenceemail3\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<p style=\"font-size: 1.2em;\">The undersigned confirms that the above information is true, correct and complete. We authorize the company to contact the listed trade references and disclose the necessary credit history for this application, including any renewals or extensions. This information may be obtained from credit agencies or relevant financial entities. All gathered data is strictly for financial evaluation.\n<\/p>\n<p>Trade references are typically verified within 2-5 business days.\n<\/p>\n<p><label> Authorized Title<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-authorizedtitlebottom\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-authorizedtitlebottom\" \/><\/span> <\/label>\n<\/p>\n<p><label>Signature <span style=\"font-style: italic;\">(please use your mouse or finger to draw your signature in the box below)<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap wpcf7-sign-wrap sign-935\"><input class=\"wpcf7-form-control wpcf7-sign wpcf7-validates-as-required\" id=\"signature\" aria-required=\"true\" aria-invalid=\"false\" name=\"sign-935\" type=\"hidden\" \/>\n            <canvas style=\"display:block\" data-hidden=\"sign-935\" class=\"signature-pad\" width=400 height=200><\/canvas>\n            <button class=\"btn btn-primary cf7sg-sign\">Clear<\/button>\n        <\/span>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Submit\" \/>\n<\/p><p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"_wpcf7_ak_\"><label>&#916;<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"0\"\/><script>document.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );<\/script><\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n\n<\/div><!-- .vgblk-rw-wrapper -->","protected":false},"excerpt":{"rendered":"<p>Any issues filling out the form? Please get in touch with us at contact@citypallets.ca Fields marked with a * are mandatory.<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"inline_featured_image":false,"footnotes":""},"class_list":["post-56066","page","type-page","status-publish","hentry"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/citypallets.ca\/cpwp\/wp-json\/wp\/v2\/pages\/56066","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/citypallets.ca\/cpwp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/citypallets.ca\/cpwp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/citypallets.ca\/cpwp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/citypallets.ca\/cpwp\/wp-json\/wp\/v2\/comments?post=56066"}],"version-history":[{"count":16,"href":"https:\/\/citypallets.ca\/cpwp\/wp-json\/wp\/v2\/pages\/56066\/revisions"}],"predecessor-version":[{"id":65067,"href":"https:\/\/citypallets.ca\/cpwp\/wp-json\/wp\/v2\/pages\/56066\/revisions\/65067"}],"wp:attachment":[{"href":"https:\/\/citypallets.ca\/cpwp\/wp-json\/wp\/v2\/media?parent=56066"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}