Candela

Credit Application

Want to do business with Candela Corporation? Just submit a credit application. First, be sure to read our General Information and Company Policy.

Please be sure to read our General Information and Company Policy before submitting your credit application. Thank you.

Billing Information

(Include Parent Company If Subsidiary)
Firm Name*
Attention*
Street Address*
Street Address 2
Billing Address (if different)
Billing Address 2
City*
State*
Zip Code*
Phone Number*
Contact E-Mail Address*
E-Mail Invoices To*

Principal Owners, Officers and Stockholders

Name*
Position*
Telephone*

Name
Position
Telephone

Please Check	Proprietorship Partnership Limited Partnership Corporation

If Corporation, list State:
If Corporation, list Date:

Bank References
At Least One Bank Reference Required

Name*
Address*
Address 2

Name
Address
Address 2

Credit References
List 3 Suppliers Whose Terms Are Net 30

Note: If possible, it is preferred that credit references NOT be other electrical wholesalers or distributors.
Name*
Fax #*

Name*
Fax #

Name*
Fax #*

Type of Business

Please Check	Resale Taxable Wholesale Distributor Lighting Dealer/Showroom Retail (type of store) Manufacturer (product) Service Other

***

We have read the terms and conditions of sale and agree to comply.

Name of Company Officer*
Title*