| Central Steel Inc.

Central Steel Account Request Form

First Name *

Last Name *

Postal Code *

Phone *

Email *

Company Name *

CSW / Referred By

Account Request - Select One *

I'm new to Central Steel, I would like to establish an account.
I'm an existing customer and I would like to request my CentralSteel.com log in.

Company Name *

D.b.a

Address Line 1 *

Address Line 2

Country *

City *

State *

Postal Code *

Phone

Fax

Contact Person - First Name

Contact Person - Last Name

Same as Purchasing

Name Line 1 *

Name Line 2

Address Line 1 *

Address Line 2

Country *

City *

State *

Postal Code *

Phone

Fax

Contact Person - First Name

Contact Person - Last Name

Preferred Invoiced Method

Payment Method Please select your order payment method. Options available are Credit Card or Terms(Line of Credit). If Terms is selected, please complete the online credit application once this form is submitted.

Note: Central Steel does not deliver to residential addresses.

Same as Purchasing

Default Ship To

Name 1 *

Name 2

Address Line 1 *

Address Line 2

Country *

City *

State *

Postal Code *

Phone

Fax

Contact Person - First Name

Contact Person - Last Name

>Receiving Hours *

Monday

Start

End

Lunch Exclusion

Tuesday

Start

End

Lunch Exclusion

Wednesday

Start

End

Lunch Exclusion

Thursday

Start

End

Lunch Exclusion

Friday

Start

End

Lunch Exclusion

Is your business tax exempt?

Yes

Default Ship To

Name 1 *

Name 2

Address Line 1 *

Address Line 2

Country *

City *

State *

Postal Code *

Phone

Fax

Contact Person - First Name

Contact Person - Last Name

Receiving Hours *

Monday

Start

End

Lunch Exclusion

Tuesday

Start

End

Lunch Exclusion

Wednesday

Start

End

Lunch Exclusion

Thursday

Start

End

Lunch Exclusion

Friday

Start

End

Lunch Exclusion

Default Ship To

Name 1 *

Name 2

Address Line 1 *

Address Line 2

Country *

City *

State *

Postal Code *

Phone

Fax

Contact Person - First Name

Contact Person - Last Name

Receiving Hours *

Monday

Start

End

Lunch Exclusion

Tuesday

Start

End

Lunch Exclusion

Wednesday

Start

End

Lunch Exclusion

Thursday

Start

End

Lunch Exclusion

Friday

Start

End

Lunch Exclusion

Default Ship To

Name 1 *

Name 2

Address Line 1 *

Address Line 2

Country *

City *

State *

Postal Code *

Phone

Fax

Contact Person - First Name

Contact Person - Last Name

Receiving Hours *

Monday

Start

End

Lunch Exclusion

Tuesday

Start

End

Lunch Exclusion

Wednesday

Start

End

Lunch Exclusion

Thursday

Start

End

Lunch Exclusion

Friday

Start

End

Lunch Exclusion

Default Ship To

Name 1 *

Name 2

Address Line 1 *

Address Line 2

Country *

City *

State *

Postal Code *

Phone

Fax

Contact Person - First Name

Contact Person - Last Name

Receiving Hours *

Monday

Start

End

Lunch Exclusion

Tuesday

Start

End

Lunch Exclusion

Wednesday

Start

End

Lunch Exclusion

Thursday

Start

End

Lunch Exclusion

Friday

Start

End

Lunch Exclusion

Company Website

How did you hear about Central Steel?

SIC Code

What will you use to unload the truck? *

Where would you prefer the material to be loaded on the truck?

What is the heaviest skid/pallet/bundle (LBS) you are able to unload? *

Would you like an Advanced Shipment Notice?

Yes

Do you need Mill Material Certifications (Material test reports - MTRs?

Additional info helpful in meeting your needs?