Wonderful Boston, Inc.

Charge Account Application

 

 

 

 

 

 

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NAME  

TITLE  

COMPANY (if corporate account)

ST. ADDRESS

CITY        STATE     ZIP    

PHONE FAX

E-MAIL

NO. OF DEPTS. USING THIS ACCT.

 

Payment Options

1. CREDIT CARD

You will receive an itemized monthly statement with the total amount,

which will be then charged to your credit card. (all major credit cards welcome!)

CARD TYPE    

NAME ON CARD  

CARD BILLING ADDRESS  

If different than above

CARD NO. 

EXP. DATE   

SEC. CODE 

 

2. MONTHLY STATEMENT

Statement will be mailed to you and is payable on receipt.

Please furnish three trade credit references and allow time for processing.

NAME PHONE

ADDRESS

NAME PHONE

ADDRESS

NAME PHONE

ADDRESS

 

Additional Information

Please provide the following information about what type of service you require:

Type of account:

If corporate, number of individuals expected to use our service:

Number of expected trips per week:

Most frequent airport destinations:

If Other, please specify:

 

Please list any special needs or concerns you may have in using our services

(besides timeliness & cleanliness, of course!)

 

Check here if you would also like to be enrolled in a voucher program.

 

I acknowledge that I am duly authorized to sign and have read and accept all terms & conditions set forth herein by Wonderful Boston, Inc.

 

   

*