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Specialty Casting
611 Court Street
Suite #10
Conway, AR 72032
(501) 327-2686

Request an Account

Only resellers within the United States that have a retail store front may qualify.
Please complete the form below and press the "Submit" button to request an account. For more information before requesting an account please review our products and service categories for guidelines on our accounts and our FAQ page. We do require a valid-current tax ID number/resale license, company information, and four trade references.

*Required

Account type*

First Name*

Last Name*

Company Name*

Company Address*

City*

State*

Zip/Postal Code*

Contact Person*

Is your company listed with J.B.T?* Yes No

Is your company rated with J.B.T?* Yes No

Tax ID*

Years in business*

Number of Employees*

Phone Number*

Fax Number

Email address*

Website

Enter 4 Trade References*

	Reference Name	Reference Phone
#1*
#2*
#3*
#4*

Comments

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