New Customer Application - Colony Packaging & Machine

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Industrial Packaging and Packaging Equipment Wholesaler across Central PA and Northern MD for 60+ Years

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1776 Colony Road
York, Pennsylvania 17408

Toll Free: 1-800-221-9577
Local: 717-764-5088

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New Customer Form

Please enable JavaScript in your browser to complete this form.

- Step 1 of 4

Business Information

Legal Company Name *

d/b/a Name (if applicable)

Phone

Fax

Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

Delivery Address *

Address Line 1

Address Line 2

City

State

Zip Code

State of Incorporation *

Business Type *

# of Employees *

Fed ID # *

SIC Code *

DUNS Code (if applicable)

Dun & Bradstreet Code

Date Established

Entity Type *

Has this company ever filed for bankruptcy? *

Date of Bankruptcy? *

Contact Information

Please fill out as fully as possible - this information helps us with deliveries, billings, and general questions.

AP Contact (first and last name) *

Title *

Email *

Phone *

Invoice Email *

Purchasing Contact (first and last name) *

Title *

Email *

Phone *

Operations Contact (first and last name)

Title

Phone

Receiving Contact (first and last name) *

Title *

Email *

Phone *

Delivery Information

Colony's operating days are M-F 8am-5pm and customers are given general delivery days to help plan and provide the best service possible.

Do any of the following apply? *

No dock door access - liftgate required
Delivery appointment required
Delivery hours differ from 7am-3pm M-F

We understand you do not have a dock door - please describe the delivery address/roadway access to your facility for deliveries. *

Please specify the contact information/protocol for delivery appointments: *

Please specify delivery hours Monday through Friday if different than 7am-3pm: *

Ordering Information

How would you like to purchase with us? *

Open Terms (preferred)
Credit Card
Check / Cash in Advance

We understand you would like to pay by credit card or check/cash in advance - after submitting this form please call our office with payment details - 717-764-5088 - ask for our Accounts Receivables Department.

Is a Purchase Order number required for us to process orders? *

Sign me up to order online, view past/open invoices, and purchasing history *

Yes
Not at this time

We're excited to have you order online withus - you will receive a seperate email with your online ordering instructions and credentials from our webmaster.

Bank Information

Bank Name *

Phone *

Contact Name *

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Trade References

We require five credit references to establish open terms.

Trade References

Name *

Contact *

Phone *

Email *

Name *

Contact *

Phone *

Email *

Name *

Contact *

Phone *

Email *

Name *

Contact *

Phone *

Email *

Name *

Contact *

Phone *

Email *

File Uploads

To establish an account we require your company W9. If you are tax exempt we also need a valid tax exemption form.

File Upload - W9 Form *

Click or drag a file to this area to upload.

.pdf files only, 10 MB

Are you tax exempt? *

Note - if we do not receive a tax exemption certificate we will charge tax until otherwise updated. If you have mixed tax requirements please select "no" and contact our accounting department directly with your specific situation - thank you!

File Upload - Tax Exemption *

Click or drag a file to this area to upload.

.pdf files only, 10MB

1776 Colony Road, York, PA 17408
Toll Free: 1-800-221-9577
Local: 717-764-5088
Fax: 717-764-5567

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Email *

Company *