Become A Distributor Business InformationCompany Name*DBA (if any)Mailing Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Shipping Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone Number*Fax Number*ASI #PPAI #Corporation or LLC?*NoYesState Incorporated*Date of Incorporation* Date Format: MM slash DD slash YYYY Federal Tax No.*Date Business Established* Date Format: MM slash DD slash YYYY Resale Tax Certificate Number*Please attach Exemption Certificate to Application (to avoid being assessed taxes)*Accepted file types: jpg, pdf, png, doc, docx.Contact InformationOwner Name* First Last Owner Phone*Owner Email* Owner Fax*Accounting Payable Contact Name* First Last Accounting Payable Phone*Accounting Payable Email* Accounting Payable Fax*Purchasing Contact Name* First Last Purchasing Phone*Purchasing Email* Purchasing Fax*Does Your Company Do More Business with Corporations or Schools?*CorporationsSchoolsWhere did you learn about A+ Career Apparel?*CommentsThe undersigned (""Purchaser"") agrees that all purchases made by the Purchaser from the date of Purchaser’s first purchase of product from A+ Apparel are subject to the following terms and conditions.• Purchaser agrees to pay any collection costs incurred to collect the account balance, including reasonable attorney's fees and court costs.• Purchaser shall immediately notify A+ Apparel of any change in ownership of the Purchaser.• The Purchaser hereby consents to the jurisdiction of the courts of the State of California in any dispute between the Purchaser and School Apparel, Inc. dba A+ Apparel. • The undersigned individual is either a principal of Purchaser or a sole proprietor of Purchaser.• Purchaser agrees to the above terms and conditions, and acknowledges that this Application may be delivered and/or returned by fax and that a facsimile signature shall be deemed to be the same as an original signature for all purposes.Signature of Applicant*Title of Applicant*Date* Date Format: MM slash DD slash YYYY
