Account Application - Cook Specialty

Online Account Application

Wholesale Account - Company Information

Date*

First name*

Lastname*

Company*

Email*

Address

Address Line 1*

Address Line 2

City*

State or Region*

Country*

Zip*

Billing Phone Number*

County (WI only)

We require three business references with which you have accounts.

Reference 1

Company Name*

Contact Person / Phone Number*

Address Info

Address Line 1*

Address Line 2

City*

State or Region*

Country*

Zip*

Email*

Phone*

Terms & Credit Limit*

Reference 2

Company Name*

Contact Person / Phone Number*

Address Info

Address Line 1*

Address Line 2

City*

State or Region*

Country*

Zip*

Email*

Phone*

Terms & Credit Limit*

Reference 3

Company Name*

Contact Person / Phone Number*

Address Info

Address Line 1*

Address Line 2

City*

State or Region*

Country*

Zip*

Email*

Phone*

Terms & Credit Limit*

Authorization and Tax Information

People Authorized to Purchase*

Comments

Tav Exemption Form*

(A fillable PDF is available from the Wisconsin Department of Revenue at https://www.revenue.wi.gov/dorforms/s-211f.pdf. Please fill out the form, sign and submit with your application.)

Business License*

(We require that you provide us with a copy of one of the following licenses: food/health, sales tax, bakery or state sellers number.)

Find it here!

Find it here!

Online Account Application

Wholesale Account - Company Information

Reference 1

Reference 2

Reference 3

Product categories

Quick Links

Information

Customer Service

Quick Links

Information

Customer Service