Luthier Application Form

Luthier Application Form

Join our FREE Luthier Level Pricing program to get up to 10% off wholesale prices on our entire catalogue*, with no minimum orders!

*All clearance items are excluded from our Luthier Level Pricing discount.
Business Information
Name of Business*
Date Business Started*

MonthDayYear
Business GST/HST #
Business Phone Number*
Please enter a valid phone number.
Business Email*
Please enter a valid email address.
Business Website URL*
What is your luthier specialty? Check all that apply.*

InstrumentsBowsOther
Address of Business*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Owner Information
Name of Business Owner*

First NameLast Name
Is the business address is the same as owner's home address?*

YesNo
Address of Owner*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Trade References
1. Name of Company*
Phone Number*
Please enter a valid phone number.
2. Name of Company
Phone Number
Please enter a valid phone number.
3. Name of Company
Phone Number
Please enter a valid phone number.
Acceptance

The applicant agrees that the Credit Terms granted by Counterpoint Musical Services are that all accounts are due and payable within 30 days from the date of invoice unless otherwise stipulated in writing and that a service charge will be paid by the customer on all amounts beyond these terms.
Signature of Applicant*

Clear
Date*

MonthDayYear
Date
Should be Empty:

Business Information