Hospitality Credit Application

Your Name *

Email Address *

Telephone Number *

Select Your Sales Representative * Ron Grogan Jason Hallquest Michael Ishayik John Lenz Earl Roloff Keith Wright Do Not Know

Hotel Name(s) *

Hotel Address(s) *

Tax ID / EIN *

Number of Rooms *

Credit Request *

Example: $1,000

Message (tell us more if you like!)

Authorization * By checking here, you hereby certify that you are an authorized agent or representative of the business above and that the above is, to the best of my knowledge, true and correct; and thus authorize, Intelligent Blends, LP, to verify the information provided strictly for the purpose of establishing credit terms for Intelligent Blends, LP. Any other use of the above provided information is unlawful.

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