New Customer Form

Thank you for your interest in partnering with The Canus Goat’s Milk Brand.
Please fill out the following New Customer Form and allow 2 weeks for processing.
On behalf of all the Goats, we look forward to working with you.

You must click here to download and read our terms and conditions
I have read and understand the Terms and Conditions (*)
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Full Legal Business Name: (*)
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Trade or Store Name: (Doing Business As): (*)
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Sales Tax ID # : (*)
Billing Address: (*)
Please use numbers only.
City: (*)
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State: (*)
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ZIP Code: (*)
Numbers Only Please
Residential or Business Shipping Address (*)
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Telephone: (*)
Numbers Only Please!
Fax:
Numbers Only Please!
Website URL:
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Shipping Address (if different from billing):
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Contact Information for authorized buyer(s)
Name: (*)
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Telephone: (*)
Numbers Only Please!
Fax:
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Email: (*)
Please format your email address correctly. It should look like this: you@yoursite.com
Accounts Payable Contact Name:
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Accts Payable Telephone No:
Numbers only please!
Accts. Payable Email:
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Number of Years in Business: (*)
Numbers only!
Are you a New Customer? (if you check Yes, please note the first 4 payments MUST be paid with MasterCard or Visa)
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Are payments to be made by credit card only? (*)
Please choose Yes or No
If yes was checked above, you will need to call Canus at 802-244-4628 with your credit card information. We will notify you when your application has been approved and direct you to call us at that time.
Trade Supplier References: (please provide the following information for 3 suppliers that you currently use if you checked the No Checkbox above)
1. Company: Contact Name: Phone: Fax:
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2. Company: Contact Name: Phone: Fax:
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3. Company: Contact Name: Phone: Fax:
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Enter Promo Code (if you have one)
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Enter the text then press the Submit button Enter the text then press the Submit button
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