new customer form

Store Name:
Buyer Names:
Address:
City:
State:
Zip code:
Phone:
Fax:
E-mail:
Website:
Do you have an ecommerce site?
Do you have other store locations?
How long have you been in business?
What other retailers do you consider a conflict?
What collections do you carry?
What denim lines do you carry?
Who is your target customer?
Preferred method of payment
Business references
Which of our collections are you interested in?

Please kindly e-mail a minimum of four photographs of your store to: marybeth@810showroom.com (Or mail directly to showroom.)
Please note: your order will not be processed without these.

Please call us if you have any questions regarding the above. We greatly appreciate your time in completing this form. You will hear back from us shortly with regard to the approval of your account.

We look forward to doing business with you!

site design james f dean