ProAccount Application

ProAccount Application
General Information
Name*

First NameLast Name
Company Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Website
Business Type
How did you hear about FloorCo. Flooring & Design Center?*
Professional Information
Years in Business*
License Number
Types of Projects

ResidentialCommercialIndustrialOther
Preferred Contact Method
Credit Line Application
Are you interested in applying for a credit line?

YesNo
Desired Credit Limit
Business Tax ID
Annual Revenue
Bank Reference
Bank Name
Bank Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Bank Account Number
Trade References (Min 3)
Company Name
Contact Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Relationship
Company Name
Contact Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Relationship
Company Name
Contact Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Relationship
Add 4th Trade Reference

YesNo
Company Name
Contact Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Relationship
Add 5th Trade Reference

YesNo
Company Name
Contact Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Relationship
Personal Guarantee

Please fill this section if line of credit is requested
Guarantor Full Name

First NameLast Name
Guarantor Social Security Number
Guarantor Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Guarantor Phone Number
Please enter a valid phone number.
Guarantor Email
example@example.com
Attachments (Upload Financial Statements, Other Documents)

Cancelof
Trade Professional Information
Describe your business and the type of services you provide
Are you interested in receiving updates on:

Special DiscountNew Product LaunchesUpcoming Events and WorkshopsIndustry News
Terms and Conditions*

I agree to the terms and conditions.
Signature

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FC Design Center Privacy Policy:

We only collect the information you choose to share with us. We process it with your consent or as legally required. We collect only the minimum personal data necessary to fulfill the purpose of your interaction with us. We never sell your information to third parties, and we only use it as described in this Privacy Statement.
Should be Empty:

ProAccount Application

General Information

Professional Information

Credit Line Application

Trade References (Min 3)

Personal Guarantee

Trade Professional Information