Sherman Party Supply Store
Alternative Solutions in Long Term Care
www.activitytherapy.makesparties.com
Application for Credit is for Party Store ONLY
Application for Credit
Company Applying:______________________________
Address: ______________________________________
City/State/Zip Code:______________________________
Contact Name: __________________________________
Phone: _________________________________________
Fax Number: ____________________________________
Financial Information:
Bank Name:____________________________________
Address:_______________________________________
Phone:_________________________________________
Bank Account Number:____________________________
All Information Must Be Complete!!!!
Reference:
1. Name: _____________________________________
Address: _____________________________________
Phone: _______________________________________Fac Fax:_______________________
Contact Name: _________________________________
2. Name: _____________________________________
Address: _____________________________________
Phone:________________________________________Fax: _______________ Fax: _______________________
Contact Name:_________________________________
3. Name:______________________________________
Address:______________________________________
Phone:_______________________________________ Fax: ______________ Fax:_______________________
Contact: ______________________________________
Date: ________________  Signature:___________________________
Title:____________________________________________________
Fax to 973 729 1560 or fill out on line and Submit  973 729 6601 for questions.
If multiple locations, please fax the names of all locations with this form, with the name of company, address, contact phone number, contact name and email address for all locations.
For questions please email activitytherapy@aol.com 
Once approved, you will be notified of your log in and discount.
This is for a 30 day billing cycle.
MUST HAVE THE ENTIRE FORM FILLED OUT TO PROCESS.