851 Ravens Point Court
Simi Valley, Ca 93065
(805) 581-0642
851 Ravens Point Court
Simi Valley, Ca 93065
(805) 581-0642
DEALER APPLICATION FORM
Please print, fill out the requested information completely and mail to
the address above to insure prompt processing of this application.
RETURN WITH PHOTOGRAPHS
(2-INSIDE OF LOCATION 1-FRONT VIEW WITH
SIGNAGE)
BUSINESS NAME __________________________________________________
PHONE __________________________ FAX ___________________________
ADDRESS________________________________________________________
CITY___________________________ STATE________ ZIP________________
YEARS IN BUSINESS_________ STATE SALES TAX NO._______________________
NO. OF OTHER LOCATIONS _________________
DESCRIPTION OF BUSINESS:
(MERCHANDISE SOLD, LOCATION, HOURS. SQUARE
FOOTAGE)
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
OTHER ART LINES CARRIED___________________________________________
________________________________________________________________
________________________________________________________________
FULL NAME OF OWNER(S),
OR AUTHORIZED OFFICER OF CORPORATION
(Please list home address and phone number for
individual or partnership)
________________________________________________________________
________________________________________________________________
PURCHASING AGENT________________________________________________
ACCOUNTS PAYABLE CONTACT _______________________________________
CREDIT REFERENCES
(Bank and two suppliers)
Include Name, Acct.#, Address and Phone Number.
1.________________________________________________________________
2.________________________________________________________________
3.________________________________________________________________
SIGNATURE ____________________________ DATE _______________________
Step 2: Print and fill out the Merchandise & Tranship Agreement