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Brunschwig & Fils Account Application
Contact Information
 
  Date
 
  Name of Account
 
  Principal(s)
 
  Phone
 
  E-mail
 
  Fax
Billing Address
 
  Billing Street Address
 
  City
 
  State
 
  Zip
Business Certification
 
  Contract
 
  Specifier
 
  Architect
 
  Residential Designer
 
  Residential Designer with Shop
 
  Design Firm
 
  Department Store
 
  Other
  Explain
 
Type of Business
 
  Proprietorship
 
  Partnership
 
  Corporation
Responsibility For Payment
 
  Contact Person
 
  Phone
 
  Fax
 
  Firm Name
 
  Address
 
  Attn
 
  Address
 
  City
 
  State
 
  Zip
Professional Experience Of Principal(S)
 
  Firm
 
  Address
 
  City
 
  State
 
  Zip
 
  Phone
 
  Contact
 
  Date of Service
Design Education Of Principal(S) (Residential Accounts Only)
 
  College
 
  Years Attended
 
  Degree
Professional Organization
  Check all affiliations:
 
  ASID
 
  NHFL
 
  AJA
 
  IBD
 
  NEWH
 
  Other Affiliation
 
  Other
Credit Information
  Type of Account Requested
 
  Open Terms - (Bank Credit Information form will be mailed to you for completion and signature)
 
  Proforma-CBD
  Additional Credit Information
 
Please provide account numbers for those firms in this industry with which you have open credit status
  Account Number:
 
  Name of Firm :
  American Textiles
  Account Number:
 
  Name of Firm :
  ARC-COM Fabrics
  Account Number:
 
  Name of Firm :
  B Berger
  Account Number:
 
  Name of Firm :
  Bailey & Griffin
  Account Number:
 
  Name of Firm :
  Ben Rose
  Account Number:
 
  Name of Firm :
  Brickel
  Account Number:
 
  Name of Firm :
  Manuel Canovas
  Account Number:
 
  Name of Firm :
  Carnegie Fabrics
  Account Number:
 
  Name of Firm :
  Clarence House
  Account Number:
 
  Name of Firm :
  Cowtan & Tout
  Account Number:
 
  Name of Firm :
  Decorators Walk
  Account Number:
 
  Name of Firm :
  Design-Tex Fabrics
  Account Number:
 
  Name of Firm :
  Donghia
  Account Number:
 
  Name of Firm :
  Duralee Fabrics
  Account Number:
 
  Name of Firm :
  F. Schumacher
  Account Number:
 
  Name of Firm :
  Herman Miller
  Account Number:
 
  Name of Firm :
  Hinson & Company
  Account Number:
 
  Name of Firm :
  J. Robert Scott
  Account Number:
 
  Name of Firm :
  Jack Lenor Larsen
  Account Number:
 
  Name of Firm :
  Knoll
  Account Number:
 
  Name of Firm :
  Kravet Fabrics
  Account Number:
 
  Name of Firm :
  Lee Jofa
  Account Number:
 
  Name of Firm :
  Maharam Fabrics
  Account Number:
 
  Name of Firm :
  Norbar Fabrics
  Account Number:
 
  Name of Firm :
  Osborne & Little
  Account Number:
 
  Name of Firm :
  Payne & Co
  Account Number:
 
  Name of Firm :
  Pindler & Pindler
  Account Number:
 
  Name of Firm :
  Scalamandre
  Account Number:
 
  Name of Firm :
  Stark
  Account Number:
 
  Name of Firm :
  Steelcase
  Account Number:
 
  Name of Firm :
  Stroheim & Romann
  Account Number:
 
  Name of Firm :
  Unika-Vaev
  Account Number:
 
  Name of Firm :
  Westgate
   
  Please mail signed and completed state tax certificate. Mail to Brunschwig & Fils Credit Department, 75 Virginia Rd, N White Plains, NY 10603
   
 
   
 

Your application will be reviewed by your local showroom.
Please feel free to contact them with any questions.
   
VIEW Spring 2009 COLLECTION