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Customer Application
Help your local Continental Home Center get a head start.
Contact Information
Step 1
First Name
*
Last Name
*
Email
*
Date of Birth
*
Phone
*
Address
*
Apt/Unit
City
*
State
*
Zip Code
*
Residency
Step 2
Residency
*
Select
Rent
Land contract
Own home
Live with friend
Time at Address
*
Select
Just moved in
1 to 6 months
7 to 12 months
Over 1 year
Monthly Payment
*
Landlord / Contact
*
Landlord Phone
*
Income Information
Step 3
Employer / Income Source
*
Employer Phone
*
How Long There?
*
Personal References
Step 4
Ref 1 Name
*
Ref 1 Phone
*
Ref 1 Relationship
*
Select
Coworker
Friend
Relative
Parent
Ref 2 Name
*
Ref 2 Phone
*
Ref 2 Relationship
*
Select
Coworker
Friend
Relative
Parent
Ref 3 Name
*
Ref 3 Phone
*
Ref 3 Relationship
*
Select
Coworker
Friend
Relative
Parent
Products of Interest
Step 5
Describe here:
*
Preferred Store Location
Step 6
Select Store
*
Choose a store
Alma
Alpena
Bad Axe
Bay City
Big Rapids
Cadillac
Caro
Charlotte
Cheboygan
Clare
Fremont
Gaylord
Grand Rapids
Grayling
Houghton Lake
Ionia
Lapeer
Manistee
Oscoda
Owosso
Port Huron
Sandusky
West Branch
Agreement
Final Step
I agree that Continental Home Center may verify the accuracy of this application, including contacting my work, landlord/housing provider, and references via phone or text.
Submit Application
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