WWW.Goodmarkfood.com Customer Application Form	Fax to : 416 628 2454.

Company Information	Company Name:___________________________________________________
Customer Type:	Coffee Shop Convenient Store Airline Golf Course Bingo Hall Cafeteria Hospital Others _________________________________________________________
Company Address:	____________ Street Number ____________________________________ Street Name ______________ Unit #
	_______________________________ City ___________________ Province ______________ Postal Code
Company Phone #:	______________________ Fax #: ______________________
E-mail address:	_________________________________________________________
R.S.T #	_________________________________________________________
Company Type:	Corporation:   Partnership:   Other:  _______________________________
Years in Business:	_____          Contact Person in Store:  ____________________________
Hours of Operation:	________________________________________________________
Payment term: All payments are to be paid C.O.D. unless credit established and approved for 7 days Post dated cheque.
Owners Information:	__________________________ First Name: __________________________ Last Name:
Home Address:	____________ Street Number ____________________________________ Street Name ______________ Unit #
	_______________________________ City ___________________ Province ______________ Postal Code
Home Phone #:	______________________ Cell Phone #: ______________________