A.I.R. Inc
P O Box 1150
411 East Monroe Street
Springfield, IL 62705
United States
ph: 217-698-8858
fax: 217-498-9978
sales
| A.I.R. Inc. Commercial Account Application |
| This application will be considered a legal and binding contract between A-I-R-Inc. and you, the Commercial purchaser, for the purpose of purchasing our product. Please print and complete the form below and fax to 217-498-9978. Your Account Number and Commercial Pricing will be returned promptly by fax or mail. Name:_____________________________________ Title:____________________________________ Organization:_____________________________ Work Phone:_______________________________ Fax:______________________________________ E-mail:___________________________________ Website:__________________________________ State Tax ID:_____________________________ FEIN:_____________________________________ Business Name:____________________________ Street Address:___________________________ Address (cont.):__________________________ City:_____________________________________ State/Province:___________________________ Zip/Postal Code:__________________________ Country:__________________________________ Thank you for your account application at A-I-R-Inc. |
A.I.R. Inc
P O Box 1150
411 East Monroe Street
Springfield, IL 62705
United States
ph: 217-698-8858
fax: 217-498-9978
sales