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Credit Application
sales | repair | installation | purchasing | customer service | tech support | quality assurance  

Apply for credit with A1 Teletronics in one of three ways:

  1. Complete this online form and click submit.
  2. Download this form as a Word document to prepare electronically and email to credit@a1teletronics.com
  3. Download this form as a PDF to print, complete offline, and fax to 727-570-2002.

Questions or comments? Consult our FAQs, email credit@a1teletronics.com, or call 800-736-4397 ext. 302.

General Information
Your name
Your email address
Legal business name
Date established
Telephone
Fax
DBA
Dun and Bradstreet number
Billing address
City
State
Zip


Company Information
President
Vice President
Treasurer
Controller
Type of company
If other, please explain:
Public company?
Yes    No
If yes, company's symbol:
Parent company (if none, please enter none)
Does parent company guarantee debts?
Yes    No
If yes, please furnish details
Parent company's address
City
State
Zip
Type of business
Number of employees
A/P contact
Credit line desired
Purchasing Agent
Is merchandise for resale?
Yes    No
If yes, tax resale number:

Trade Credit References
At least two references required. Use names of only those open accounts you buy from.
Reference 1
Name
Telephone
Fax
Acct. No.
Address
City
State
Zip

Reference 2
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Telephone
Fax
Acct. No.
Address
City
State
Zip

Reference 3
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Telephone
Fax
Acct. No.
Address
City
State
Zip

Reference 4
Name
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Acct. No.
Address
City
State
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Bank References
At least one reference required. You MUST have an account.

Bank Reference 1
Bank name
Checking acct. no.
Address
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Zip
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Fax
Account Officer

Bank Reference 2
Bank name
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Address
City
State
Zip
Telephone
 
Fax
Account Officer




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As an independent distributor, A1 Teletronics, Inc. is not affiliated with Nortel Networks Ltd. or Avaya, Inc. Independent Knowledge™ is not sponsored or endorsed by, or affiliated with, Nortel Networks Ltd. or Avaya, Inc. Nortel®, Norstar®, Meridian®, Meridian 1®, Meridian SL®, and Callpilot® are registered trademarks of Nortel Networks Ltd. Avaya®, Partner®, Merlin Magix® and Definity® are registered trademarks of Avaya, Inc. Polycom® is a registered trademark of Polycom, Inc. Plantronics® is a registered trademark of Plantronics, Inc. BICSI® and RCDD® are registered trademarks of BICSI, Inc.