Customer Information Form

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Cornille's customers range from Country Clubs and Delis to some of the country's most famous Restaurants and Hotels. We sell to large National Suppliers and small Corner Stores. Our 80 years in business is testimony to our dedication to customer service and fine quality.

To open a new account with Cornille, fill out the form below and someone will contact you promptly.

Customer Name: Billing Name:

Street Address:

City: State: Zip Code:

Billing Address:

City: State: Zip Code:

Telephone: Ext. Fax:

Email: Web Address:

Resale Tax Number:

Contact: Receiving Contact:

Chef Contact: Kitchen Contact:

Trade Reference: Phone:

Trade Reference: Phone:

All information submitted is kept strictly confidential.

PHONE ORDERS: (312) 226-1015

© 2006 George J. Cornille & Sons, 2404 S. Wolcott Ave, Chicago, IL 60608