Dealer Application

Business Name*

Business Type (check all that apply)

Brick & MortarOnlineTrade ShowsOther

Business Description*

Business Website*

Business Phone*

Area CodePhone Number

Business Fax*

Area CodePhone Number

Reseller ID*

Federal Tax ID*

Bill To Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry

Ship To Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Main Contact*

NameTitle

PhoneEmail Address

Secondary Contact

NameTitle

PhoneEmail Address

Desired Payment Terms
Please note that any terms other than prepayment* will require the completion of a credit application. Credit application will be provided if dealer application is approved.

Payment Terms*

PrepaymentCODNet 30Other

*Prepayment types accepted: Visa, MasterCard, Discover, cashier's check, money orders, and wire transfers. All international customers will be required to prepay via wire transfer. (American Express not accepted)

Personal Guaranty
In consideration of extending credit, the undersigned, hereby individually and personally guarantee to pay all sums of money that, hereinafter, become due whether said indebtedness be in the form of notes, bills, open account, or any other form

The undersigned agree(s) to pay reasonable attorneys’ fees, collection costs and court costs which may be incurred through the enforcement of this Guaranty by the creditor. The undersigned agrees that this agreement shall be interpreted under the laws of the State of TEXAS and agrees that the venue for any action brought by EMCO Supply, Inc. to enforce any terms of the Guaranty Agreement shall be in MCLENNAN County, at the option of the creditor.