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Rapid Response > Open an Account

*Your Name

*Company Name


*Address

*City

*State

*Zip
*E-mail Address

*Telephone Number

Fax Number
Your Position

Type Of Business

If Other, Please Specify

Due to the legality of opening an account, it is necessary for Becker Electric to mail or fax you a credit application, so we have your authorized signature on file.

If you choose to fax back the signed credit application, you will still need to mail us the original signed copy.

Most requests are handled in 1-2 business days.

Please send my credit application by:
Mail
Fax


Please fill out the form completely and hit the Submit button below.

* Indicates a required field.

To contact a branch directly, by either telephone or fax, choose a location from the list on the left.

If you have a general question, you can send email here: General Questions

 
 
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