Contact information:
Business name:
Contact person:
Contact email address:
Contact fax:
Mailing address:
Tax ID number:
Business type?	Department Store Hat Shop Boutique Other
Business references:  (Company, Contact, Address, Phone, Fax)
Reference 1:
Reference 2:
Reference 3:
Banks reference:  (Name, Contact, Address, Phone, Fax)
Bank:
Account #: