ACCOUNT APPLICATION – PUBLIC ORGANIZATION
Goodheart-Willcox Publisher
18604 West Creek Drive ? Tinley Park, IL 60477-6243 g- ? custserv@g-
Orders 1-800-323-0440 Phone 1-708-687-5000
Fax 1-708-468-8692
ACCOUNT APPLICATION ? PUBLIC ORGANIZATION
Name of Organization ______________________________________________________________ Billing Address_______________________________________________________________________ City __________________________________ State ____________ Zip Code ____________________
(_____)________________(_____)_________________ _____________________________________
Telephone
Fax
E-mail ? for emailed invoice
Prepay shipping (included on invoice)
Please use our attached routing instructions
Ship to address (if different from bill to address)______________________________________________
City __________________________________ State ____________ Zip Code ____________________
(_____)________________(_____)_________________ _____________________________________
Telephone
Fax
E-mail
Will purchases be drop shipped? ____Yes ____No If yes into what state(s): ___________________ (Attach sheet if necessary)
Will your purchases be subject to sales/use tax? _____Yes _____No
If no, please provide a current TAX EXEMPTION CERTIFICATE with your completed account application
Accounts Payable Contact:
___________________________________________________________________________________ Name
____________________________ (_____)_____________________
Email
Telephone
The undersigned verifies that the information submitted is true and correct.
___________________________________ __________________________________ __________
Name (Please Print)
Title
Date
___________________________________ Signature
PLEASE RETURN TO: accounting@g-
Goodheart-Willcox Publisher
18604 West Creek Drive ? Tinley Park, IL 60477-6243 g- ? custserv@g-
Orders 1-800-323-0440 Phone 1-708-687-5000
Fax 1-708-687-5068
Below is Goodheart-Willcox Publisher's preferred method of payment:
Please supply this information to your accounts payable department and/or general accounting department
Vendor Information
Federal Employer Identification Number: 36-2135994
E-Mail Address: accounting@g-
Name: Goodheart-Willcox Co, Inc.
Financial Institution Information
Name of Financial Institution: Chase
Address of Financial Institution: 10 S Dearborn Chicago, IL 60603
Representative's Name: Mary Marciniak Routing Number: 071000013
Phone: 312.732.6898 Account Number: 757313882
We also accept credit card and checks via mail: Goodheart-Willcox Publisher ATTN: Accounts Receivable 18604 West Creek Drive Tinley Park, IL 60477
Thank you.
Accounting Department Goodheart-Willcox Publisher
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