Martin & Company Design, Inc.: Applications

Customer Credit Application:   Select PDF format    Microsoft Word format
Order Form:    PDF format
Credit Card Authorization:    PDF format
Dealer Application:    PDF format    Microsoft Word format

BUSINESS INFORMATION
Applicant’s legal name:
Operating as (DBA):
Phone:
Fax:
E-mail:
Internet website:
Can we send you emails with product information?	Yes No
Sales Tax Number/State Issued:
Federal EIN:
Storefront address:
City:
State:
ZIP Code:
SHIPPING ADDRESS (IF DIFFERENT):
City:
State:
ZIP Code:
Type of store: (check all that apply)	Retailer Consultant Storefront Commercial Studio Home
Number of locations:
Avg. orders taken monthly:
Requesting Trade Credit:	Yes (please submit Credit Application) No

Detailed description of store:

Upon approval, we would like to list your company as an authorized dealer (including relevant contact information) on the Martin & Company website. Do you authorize us to make such disclosure?

Yes No

OWNER(S)/PRINCIPAL OFFICERS (ATTACH EXTRA SHEET IF NECESSARY):
Name:		Title:
Phone:		Fax:
Email:
Name:		Title:
Phone:		Fax:
Email:

SALES INFORMATION
Percentage of sales BABY related:
Percentage of sales HOLIDAY related:
Percentage of sales everyday OCCASION related:
Percentage of sales WEDDING related:
Percentage of sales related to BOXED SETS & IMPRINTABLES:
Do you sell wrapping papers?	Yes No
If Yes, in:	flat sheets rolled sheets Both flat and rolled sheets

What other stationery items/functions do you find your store selling well?

What other stationery lines do you currently carry:

PRODUCT INTEREST

What Martin & Company products are you interested in (check all that apply):

Premiere Baby
Premiere Holiday
Premiere Occasion (Coming Spring 2006)
Boxed Note Cards
PK Papers Imprintables
Chica Wraps (wrapping paper – coming soon)

Any other products you may be interested in?

Tell us how you heard about us:

ACKNOWLEDGEMENT:

1. By signing this Dealer Application, each individual signing below, individually and personally represents and warrants to Martin & Company Designs, Inc. (“Martin & Company”) that:
a. He/she is authorized to execute this Application on behalf of Applicant;
b. The information set forth in this Application and Agreement is accurate and complete; and
c. Applicant is solvent and pays its obligations as they become due.
2. By signing this Dealer Application, you acknowledge that Martin & Company is relying on the information contained herein and your representations and warranties above in making its decision to establish a business relationship with you.
3. This is not a credit application. If you intend to establish trade credit, please submit a completed Credit Application in the form provided to you with this Application.
4. Martin & Company shall have the right to discontinue the sale of any items in any of its albums in its discretion.