Catalogue - AMA Plastics

Visit us on-line: amaplas.com
Customer Information
CuStOMER InFORMAtIOn
Business Name: _________________________________________________________________________________________________________
Billing Address: _________________________________________________________________________________________________________
City: ___________________________________________ Province/State: __________________ Postal/Zip Code: _____________________
Shipping Address: (if different than above)__________________________________________________________________________________
City: ___________________________________________ Province/State: __________________ Postal/Zip Code: _____________________
Owner’s Name: ______________________________________________ Contact Name: _____________________________________________
Business Phone: _____________________________________________ Fax Number: _______________________________________________
Alternate Phone: _____________________________________________ Email: _____________________________________________________
Is a purchase order required? Yes � No � Loading Dock? Yes � No � Forklift? Yes � No �
Business Description:
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
To help us classify your account, please circle all information that applies:
A. Bedding Plants G. Propagation M. Landscaper S. Golf Course
B. Roses H. Wholesale Sales N. Grounds Management T. Other (Specify)
C. Easter Lilies I. Retail Sales O. Interiorscape ____________________________
D. Geraniums J. Garden Center P. School/Institution ____________________________
E. Poinsettias K. Greenhouse Q. Fruits/Vegetables
F. Plug Production L. Nursery R. Extension/Educators
6 Call or e-mail your order... 800-338-1136 • ama@amaplas.com