Phone: (847) 742-1790 Monday - Friday: 7:30 a.m. - 4 p.m. Saturday: Closed

Customer Number Application

To apply for a customer number, please complete the form below. This form is not an application for terms or credit. Credit applications are available under Resources/Forms.

* = Required Field

"*" indicates required fields

Application Type (check one or both):

Midwest Groundcovers Application?*
Midwest Trading Application?*
Please check the appropriate box below.*
Bill To Address*
Ship To Address (if different than bill to)
How will you receive your orders most frequently?*

Business Identification Information

NOTE: If you do not have a Federal Employer Identification Number (EIN), please provide 2 proofs of business such as a: voided business check, business license, state certificate of business registration, membership in a professional association, trade association or chamber of commerce. Additional information may be requested to set up your account. For more information, contact our Customer Service Department.

Would You Like to Apply for Credit Terms?*
Would you like to put your credit card on file?*

By checking “Yes”, a sales representative will contact you to receive your information. Credit applications are available separately.

Contact Information

Do you require a Purchase Order # or Job Name on your orders?

Primary Business

Select Your Primary Business
Are you tax exempt?*
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Contact Info

Phone: (847) 742-1790
Fax: (847) 742-2655
mginfo@midwestgroundcovers.com

Street Address

6N800 IL-25
St. Charles, IL 60174

Current Hours

Monday - Friday: 7:30 a.m. - 4 p.m. Saturday: Closed

 

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