Credit Application

At Palisade Picket & Paling Co. you can get your credit process started immediately. Just fill out the appropriate information in this form and you're well on your way to having your Fencing Requirements fulfilled.
You may Print this form and forward it to us or submit it directly online.
#Please note: All questions must be filled out to process your request.

Last Name:
First Name/ Middle Initial
E-mail:
Date of Birth/Number of Dependants:
Home Phone Number:
Fax Number:
Present Address:
City:
State:
Post Code:
Years at present location:
Previous Address:
City:
State:
Post Code:
Present Employer
Employer's Phone Number:
Employer's Title/Occupation:
Employer's Address:
City, State, Post Code:
Years of Service
Net Monthly Income
Previous Employer:
Previous Employer's Phone:
Years of Service:
Residential Status:
Landlord Name: (if applicable)
Please note that by submitting this form you give your authorisation for Privacy Act, Credit Reference Check.
Question's or Comments