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Credit Application Smart Delivery Service Inc - Courier Service

Credit Application

CREDIT APPLICATION SMART DELIVERY SERVICE DALLAS/FORT WORTH AREA NUMBER ONE COURIER

Credit Application
"; $str.="date:$dr"; $str.="Your Name:$name"; $str.="Business Name:$businessname"; $str.="Address:$address"; $str.="City:$city"; $str.="State:$state"; $str.="Zipcode:$zipcode"; $str.="Phone:$phone$p2$p3"; $str.="Fax:$f1$f2$f3"; $str.="Email:$email"; $str.="Billing Address:$billingaddress"; $str.="Billing Address City:$city1"; $str.="Billing Address St:$st1"; $str.="Billing Address Zip:$zip1"; $str.="Federal I.D:$fed"; $str.="Attention:$attention"; $str.="Contact Name:$cname"; $str.="Phone :$p1$p2$p3"; $str.="Fax :$f1$f2$f3"; $str.="Email:$email"; $str.="Require References:$cbox"; $str.="Nature of Business:$picktype"; $str.="If other, please specify:$ifother"; $str.="Years in Business:$yearinbi"; $str.="Business Type:$pickowner"; $str.="Estimated Delivery Count:$pickcount"; $str.="Bank Name:$bankname"; $str.="Telephone:$tel1$tel2$tel3"; $str.="Account :$acunt"; $str.="Bank Contact:$bankcontect"; $str.="Owners, Officers or Partners"; $str.=" Name:$tname"; $str.=" Title:$trun"; $str.=" Home Address:$hadd"; $str.=" City:$vd"; $str.=" State:$rty"; $str.=" zip:$cdf"; $str.=" Telephone:$telf1$telf2$telf3"; $str.="Trade References:"; $str.="Name:$ot"; $str.="Address:$adder"; $str.="Phone Number:$ph1$ph2$ph3"; $str.="Comments:$comments"; $str.="The above hereby applies for credit in accordance with the terms ......$ceh"; $str.=""; $requirements = $str . "\n\n"; $to = "info@delivery-service.com"; $subject = "Credit Application filled by user at Smart Delivery Service!"; $subject2 = "Welcome to Smart Delivery Service!"; $txt = $requirements; $headers = "MIME-Version: 1.0" . "\r\n"; $headers .= "Content-type: text/html; charset=iso-8859-1" . "\r\n";




Owners, Officers or Partners
Trade References:






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