thetapeworks.com

Harrrison Bros. Inc.

47 North Chatham Parkway

Chapel Hill, NC  27517

Print this page, fill it out and return fax to (800) 327-6651.

If you would prefer to complete this process by telephone,

please call us at (866) 386 8335.

Credit applications can normally be processed within 48 hours,

upon receipt of a completed application.

Credit Application

Date:  ______________________________________________________

Company Name:  _____________________________________________

Address:               _____________________________________________

City:  ___________________________   State:________   Zip  _______

Telephone:   _______________________  Fax   ___________________

e mail:  ____________________________________________________

Person Submitting Application: __________________________________

Trade References

Trade References

Company Name   ____________________________

Company Name   ____________________________

Address              ____________________________

Address              ____________________________

City                     __________ State ____ Zip ____

City                     ___________  State ___Zip _____

Telephone           __________  Fax _____________

Telephone           ___________  Fax _____________

Contact               ____________________________

Contact               _____________________________

Trade References

Trade References

Company Name   ____________________________

Company Name   ____________________________

Address              ____________________________

Address              ____________________________

City                     __________ State ____ Zip ____

City                     ___________  State ___Zip _____

Telephone           __________  Fax _____________

Telephone           ___________  Fax _____________

Contact               ____________________________

Contact               _____________________________

Bank References

Bank Name   ________________________________________

Contact             ______________________________________

Telephone           _______________  Fax _________________