Appliance Specialists now offers open accounts to purchase parts. A credit card is no longer required. To order parts on account please complete this form. We have worked to make it as easy as possible for you to complete, but we do need some basic info in order to set up your account.

Once received and approved you will receive a follow-up email with information on your account and instructions on how to order parts on account.

General Company Information

Type of Business(Required)

Primary Contact


Shipping Information

Primary Shipping Address

Billing Information

Primary Billing or Accounting Contact
Billing Mailing Address