Personal Credit Application
Thank you for taking the time to apply for a house account at Emmerson Lumber and Cottage Country Building Supplies !
We have designed this secure "on-line" form to speed the process up. We generally process an application within 24 hours.
Personal Information
We will take all reasonable steps to protect the privacy of this information in accordance with the terms of the Personal Information Protection and Electronic Documents Act.
Name of Primary Applicant
Your answer
Mailing Address- Street or P.O. Box #
Your answer
City or Town
Your answer
Province or State
Your answer
Postal Code or ZIP Code
Your answer
Home Telephone Number
Your answer
Cellular Phone Number
Your answer
Cottage Phone Number
(If applicable)
Your answer
E-Mail Address
We will send your bills to this address in a .pdf form on the first day of every month
Your answer
Birthdate
Your answer
Social Insurance Number
This is a cross check to verify that you do not get confused with another person with a similar name.
Your answer
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