Account Request

The Granite Group Account Request Form

Use this form to create a Granite Group account to order Cash On Delivery (COD). Pay via Cash or Credit Card

Completing this form will submit the information necessary for The Granite Group Accounts Receivable department to setup your company with a Granite Group COD account so you can place orders in the branch or Online.

First Name

Last Name

Phone Number

Mobile Number

Email

Company Name

Billing Address

Address Line 1

Address Line 2

City

State

Postal Code

Shipping Address

Address Line 1

Address Line 2

City

State

Postal Code

Company Type

Preferred Branch Location

Enable Access to Online Store

Purchase Order Number Required

Job Name Required For Purchase

Accept Item Back Orders