Patternmaster New Dealer Information Request

Business Contact Information

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Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Preferred Invoice Delivery {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Business Website {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Shipping Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Business Shipping Information

Shipping Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Is your business ONLY internet based? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Is your business a member of a buying group? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Would you like to be listed on our website Dealer Locator? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Please list your retail store address and phone number for the public to see. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Other Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Business/Trade References

Reference #1
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Reference #2
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Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Reference #3
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Agreement

1. All new vendors must place a 10 tube minimum order with payment made by credit card; unless other arrangements have been made in advance.

2. Terms are Net 30

3. All late payments will be charged 1.5% late fee that accrues each month beyond Net 30

4. Claims arising from invoice discrepancies must be made within 7 working days.

5. By signing this agreement you have authorized Patternmaster Chokes, LLC to make inquiries into the Business/Trade References that you have listed.

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Signatures

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Thank You! We are glad to do business with you!

Patternmaster New Dealer Information Request

The email has been sent.

Your progress has been saved.

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Patternmaster New Dealer Information Request

Business Contact Information

Business Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Years in Business {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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US Company Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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International Company Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Billing Contact Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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US Billing Contact Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Billing Contact Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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International Billing Contact Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Preferred Invoice Delivery {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Buyer Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
US Buyer Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Buyer Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
International Buyer Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Business Website {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Shipping Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

Business Shipping Information

Shipping Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Shipping Contact Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Shipping Contact Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Shipping Contact Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
{ binding firstError.message }
Is your business ONLY internet based? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Is your business a member of a buying group? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Which group? (NBS, Sports Inc, etc) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Would you like to be listed on our website Dealer Locator? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Please list your retail store address and phone number for the public to see. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Other Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

Business/Trade References

Reference #1
Company Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Type of Account {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Reference #2
Company Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Type of Account {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Reference #3
Company Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Type of Account {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }

Agreement

1. All new vendors must place a 10 tube minimum order with payment made by credit card; unless other arrangements have been made in advance.

2. Terms are Net 30

3. All late payments will be charged 1.5% late fee that accrues each month beyond Net 30

4. Claims arising from invoice discrepancies must be made within 7 working days.

5. By signing this agreement you have authorized Patternmaster Chokes, LLC to make inquiries into the Business/Trade References that you have listed.

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Signatures

Signature {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Name and Title {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Date Signed {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
{ binding firstError.message }

Thank You! We are glad to do business with you!