By clicking this box, you are consenting to the use of your electronic signature as a valid acceptance and submittal of this application to Hercules Industries, Inc. (“Hercules”). Please know that in order to transact business with Hercules your consent to an electronic signature or transmission is not required and you may instead request and complete this application in a non-electronic form (which is also available) should you wish by calling our credit department at 303-937-1000 or sending an email to acctrec@hercmail.com. You may also subsequently elect to withdraw your acceptance of the use of your electronic signature at any time using the same methods to contact Hercules. Of course, should this election later be made, you will be asked to submit a new application in a non-electronic form prior to conducting any further business with Hercules. So that you are aware, Hercules will store your application electronically for as long as it is valid, and you continue to conduct business with Hercules. You can make a written request to Hercules for a copy of this application at any time should you wish, but also know that any transactions associated with the account can be accessed via the assigned web portal account at any time. As a final consideration, should you not transact any business with Hercules for a period of three (3) years, your application shall then be automatically electronically destroyed by Hercules.
