Credit Application

Company Name(Required)

Registered Business Name

Contact Name(Required)

Who will be the point of contact for the Credit Application

Contact Email(Required)

The credit department will email the customer with a credit application

Customer Phone number(Required)

The customer that will be purchasing tires from EBT.

EBT Salesperson(Required)

Salesperson assigned to customer.

EBT Salesperson Code(Required)

Enter your SPC

EBT Salesperson Email(Required)

Confirmation will be sent to this email address. This should be an @eastbaytire.com email

Profit Center(Required)

Comments

Anything additional to add

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2200 Huntington Dr., Unit C
Fairfield, CA 94533