Dealer Application Form
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1STEWART SURFBOARDS
2102 South El Camino Real
San Clemente, CA 9272
Phone (800) 265-8882
Phone (949) 492-1085
FAX (949) 492-2009
DEALER APPLICATION
Name of Shop _________________________
Owner’s Name ___________________
Address
___________________________________________________________
City
___________________________ State _________ Zip _____________
Business Phone___________________________ Fax ___________________________
Home Address ___________________________________________________________
City
___________________________ State _________ Zip _____________
Home Phone ___________________________ Fax ___________________________
How long in business? ____________________ Manager’s Name _________________
Social Security #
_____________________ Federal Tax ID# _________________
State Resale #
_____________________
Bank Name
___________________________ Account # ______________________
Bank Address ___________________________________________________________
Bank Phone # ___________________________
TRADE REFERENCES
Name
___________________________ Account # _________________________
Address
__________________________
Phone # & Fax #
____________________________
City
___________________________ State _________ Zip _________________
Name
___________________________ Account # _________________________
Address
__________________________
Phone # & Fax #
____________________________
City
___________________________ State _________ Zip _________________
Name
___________________________ Account # _________________________
Address
__________________________
Phone # & Fax # ____________________________
City
___________________________ State _________ Zip _________________
Name
___________________________
Account # _________________________
Address
__________________________
Phone # & Fax #
____________________________
City
___________________________ State _________ Zip ________________
Stewart Surfboards has my permission to check all bank and trade references
Signature __________________________
I give my bank permission to give this information to Stewart Surfboards.
Signature __________________________
PLEASE ENCLOSE MOST RECENT FINANCIAL STATEMENT
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Parent category: Business