AlemUnitedExpress

Corporate Account Application Form

To apply for a Corporate Account, please fill in the application form below.

Contact Details

Business Name

Contact Name (First - Last)

E-Mail Address

Verify E-Mail Address

Business Telephone:

Contact Telephone:

Fax

Business Address

Address Line 1

Address Line 2

City:

State:

Zip:

Mailing Address
Check if same as above

Address Line 1

Address Line 2:

City:

State:

Zip:

Business Information

Is this Business Incorporated?	Yes No
If so, number of years in Business:
State of Incorporation:
Federal Tax I.D Number
Description	Please give a brief description of your Business:
Description
Has this company ever filed for bankruptcy?	Yes No

Other Information

Do you require a purchase order to be issued?	Yes No
If so, Contact Name
Phone Number:
Your Name:
Position:
Create Username and Password to access your account.
Username:	( upto 16 characters. no spaces)
Password:
Verify Password:

Legal Statement

In the event that this credit application is approved, the applicant hereby agrees to and accepts the following terms and conditions: FULL PAYMENT SHALL BE DUE UPON RECEIPT OF STATEMENT. 
	
In the event that the account remains unpaid and legal fees therefore are incurred by Alem United., to obtain payment for services rendered or for information and assistance Alem United may require from whatever source it deems necessary to obtain payment, the applicant shall be held accountable for all expenses incurred in the collection process, including reasonable attorney fees.

The undersigned on behalf of the applicant authorizes Alem United to conduct a complete and thorough check of all the information supplied to Alem United. Furthermore, the applicant certifies that the above statements are true, correct and complete and have been made by the undersigned for the purpose of inducing Alem United, to extend credit to the applicant knowing that LèYoh Transport, will rely thereupon, furthermore the undersigned is fully aware of  Alem United cancellation, reservation and billing policies.