Application for Credit

For shops interested in establishing an account with me, please fill out the
Application for Credit, below, print it out and send it to me along with your
PRE-PAID, FIRST TIME order (be sure to include the proper P/S/H in the
total amount remitted).  Thank you!    Back to Forget-Me-Nots In Stitches Home Page

Name of Shop _________________________________________________________________

Re-sale Number of Sales Tax I.D. Number ___________________________________________

Address _____________________________________________________________________

City ________________________________ State ___________ Zip _____________________

Telephone Number with area code __(___________)___________________________________

Fax Number with area code ______(___________)_____________________________________

Email address ________________________________________________________________

Type of Business:  ____ Partnership ____ Corporation ____ Sole Proprietor

Owner(s) Name ______________________________________________________________

Home Address ______________________________________________________________

City ________________________________ State ___________ Zip _____________________

Home Telephone Number with area code __(____________)______________________________

Credit References:

1. _________________________________________________Acct. #____________________

2. _________________________________________________Acct. #____________________

3. _________________________________________________Acct. #____________________

4. _________________________________________________Acct. #____________________

Please read carefully:  All outstanding balances are due 30 days from invoice date. 
Invoices not paid in full within 30 days are subject to a late fee of 2.5% per month. 
Balances outstanding after 60 days will be charged to the credit card number, as authorized,
and future shipments will be pre-paid.  Authorization is hereby given to make appropriate credit
investigations, and to obtain and exchange any information we may receive from other sources.

Visa or Mastercard Number: _______________________________ Exp. Date ______________

I hereby agree to the above terms and conditions:

Authorized Name (please print)____________________________________________________

Signature ____________________________________________________________________