Please fill out the following information

Credit Application Form

This is to authorize Jason Alexander Co. and/or its companies to except email/fax/phone orders from our business, charge the cost of this/these order(s) to my credit card account and ship the merchandise that Is requested. By authorizing this document, I/we are accepting all responsibility for these transactions to ensure full payment to the merchant. (We will inform you if this order is no longer valid)

Thank you!