Open a catering account with rebecca's cafe. Please fill out the form below completely.

Company Name:


  Address & Suite #:

City:


 
State:


Zip Code:

Department:


  Contact Name:

Daytime Phone:


  Fax Number:

Email Address:


  Type of Business:

# of Years in Business:


  # of Employees:

Federal Tax ID #:


  DUNS #:


List Bank Reference & 3 Trade References If DUNS # unavailable


Accounts Payable Mgr:


  Accounts Payable Mgr E-mail:


Accounts Payable Mgr Phone:


  Billing Address (if different):