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Credit Application
We welcome your interest in doing business with our company! All information submitted will be held in strictest confidence and used solely for reference purposes within our credit department.
It will take about 3 ~ 5 days to response your inquiry.


* indicates the required field.
   * Amount of credit requested $: (Minimum $1500)   
      DUNS/Tax ID #:   
1. TELL US ABOUT YOUR COMPANY: * indicates the required field.
   * Is Your Organization Sales Tax Exempt?    Yes No
   * Is a Purchase Order Required?    Yes No
   * Full Legal Name/Business Entity:   
   * Doing Business As:   
   * Telephone Number:     Fax Number:
   * Street Address:       * City:       * State:       * Zip:   
     Mailing Address:         City:           State:         Zip:   
  (if Different)
  * Type of Business:   
  * Company Web Address:   
2, ACCOUNT INFORMATION: * indicates the required field.
   * Name of Main Contact:          * Email Address:   
   * Telephone Number:                Fax Number:       
   * Authorized Purchasers:   1.   2.
  3.   4.
  5.   6.
     Accounts Payable Contacts:   1.   Phone:
  2.   Phone:
  3.   Phone:
I authorize Wine County Gift Baskets, 4225 N. Palm Street, Fullerton, CA 92835-1045 to receive full information as requested relating to our credit experiences. Wine Country Gift Baskets reserves the right to request any additional information as pertaining to your credit history.
I affirm that all information provided is correct.

By typing your name below, You agree that this is valid as your signature.

Cybertrust Certified Logo;
Welcome to Wine Country Gift Baskets offering the best selection online of value-priced, handcrafted gift baskets & gift towers, including corporate gift baskets, business gift baskets, anniversary gift baskets, birthday gift baskets, gourmet gift baskets, chocolate gift baskets, holiday gift baskets, Christmas gift baskets, Father's Day Gift Baskets, fruit baskets, spa gift baskets, coffee gift baskets & tea gift baskets. Whether you need to purchase distinctive corporate gifts or buy something for friends and family, we have unique gift ideas to suit your taste & budget. All of Wine Country Gift Basket's gifts are backed by our Best Value and 100% Satisfaction Guarantee.
Copyright 2014 Wine Country Gift Baskets - Wine Country Gift Baskets® and
Wine Country® are registered trademarks-All rights reserved. (800) 394-0394
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