New Customer Application

Welcome New Customers!

Here you have the ability to apply to become an offical customer of Ultra Carbide. Once you become an Ultra Carbide customer you will have access to the following.

Check Inventory
Pricing
Online Ordering
Saved Lists

Before you can enjoy everything Ultra Carbide has to offer you must complete all sections below. Once completed we will review the application and get back to you with the results. Approved applicants will be sent an invitation to set up an account. If you have any questions or concerns please contact us.

An ACH or credit card prepayment will be required before the first order can be shipped.

Phone: (248) 446-1744
Email: sales@ultracarbide.com

Referral

Referral Company:

Referral Contact Name:

Referral Contact Email:

Referral Contact Phone:

Primary Contact Information

Name:

Email:

Phone:

Fax:

Accounts Payable Contact Information

Name:

Email:

Phone:

Fax:

Billing Information

Address:

City:

State:

Zip Code:

AP Contact Name:

AP Contact Email:

Shipping Information

Street Address:

City:

State:

ZIP Code:

Preferred Courier:

Shipping Method:

Freight Collect Account #:

UPS Quantum Name (Optional):

UPS Quantum Email (Optional):

Request Customer Portal Website Invites

Please provide the email addresses for all account users you wish to receive invitations.

Additional Information

Material Certifications Required?

W-9 Attachment: PDF or image formats accepted. Upload

Tax Exempt Certificate: Only required if your organization is tax exempt. Upload

Tax Exempt Certificate is required proir to orders being placed. Terms are Net Thirty (30) days after account is approved.

Customer Credit Application

It is required to provide 3 Credit References (Commercial Only). Please provide Company Name, Contact Name and email or fax number to send requests to. Only USA Referances! References without vaild Email or Fax will not be contacted. 3 Credit References must be returned to astablish Credit Limit Terms.

Already have a document that provides your credit references? You may attach the a credit reference document as an alternative option.

Only paying with Credit Card? Please check the Credit Card Only option.

(In order to submit the form one of the following must be completed.)

Please check the box below if you will only be making credit card purchases.

Credit Card Only

Upload

Credit Reference #1

Company Name:

Account Number:

Contact Person:

Email:

Fax:

Credit Reference #2

Company Name:

Account Number:

Contact Person:

Email:

Fax:

Credit Reference #3

Company Name:

Account Number:

Contact Person:

Email:

Fax:

Notes:

*Invoices / Statments will be delivered via Email

New Customer Application

Welcome New Customers!

Referral

Company Information

Primary Contact Information

Accounts Payable Contact Information

Billing Information

Shipping Information

Request Customer Portal Website Invites

Additional Information

Customer Credit Application

Credit Reference #1

Credit Reference #2

Credit Reference #3