Wholesale
Credit Application
Update Account
Product List
Print Order Form
HomeAbout AstaraMembershipStoreBook SellersSearchContact
EventsNewPrayerSupportArt CollectionLinksKids Corner

Astara

10700 Jersey Blvd., Suite 420
Rancho Cucamonga, CA 91730
Fax: (909) 948-2016

In order to extend credit, we need all information requested on this form. If you have any questions, please contact Astara's Director of Operations or Accounting Manager at (909) 948-7412. Terms are Net 30 days on all orders. First order for all new customers must be prepaid. If you prefer, you may print a PDF copy of this form and fax or mail it.

Secure Credit Application

Company/Organization Name
Sales Tax Exemption #
Type of Company/Organization
Phone
   # of Years in Existence
Your Name & Title
Your Email Address
Business Billing Address
 Billing Address (line 2)
City
State/Province
Zip/Postal Code
Country (if not U.S.A.)
Shipping Address
(if different)
Address (line 2)
City
Zip/Postal Code
State/Province
Country (if not U.S.A.)

Please List Three Business References Below:
1.       Business Name
Contact Name & Title 
 Phone
Address
 (Line 2)
City
State/Province
Zip/Postal Code
 Country (if not U.S.A.)
2.       Business Name
Contact Name & Title 
 Phone
Address
 (Line 2)
City
State/Province
Zip/Postal Code
 Country (if not U.S.A.)
3.       Business Name
Contact Name & Title 
 Phone
Address
 (Line 2)
City
State/Province
Zip/Postal Code
 Country (if not U.S.A.)

   


© 2007 Astara, All rights reserved