David & Goliath
New Account Application / Terms
New Account Application / Terms
Fields in red are required.
CORPORATE INFORMATION
Corporate Name:
 dba
Address
 City
State/Locality
 Postal Code
Country
Describe the nature of your business
Phone Number
 Years In Business
 Number of Locations
Federal Tax ID #
 State Tax ID #
 Dun & Bradstreet Rating
Operating Office/Owner
 E-Mail Address
Phone Number
 Ext
 Fax Number
Buyer Name
 E-Mail Address
Phone Number
 Ext
 Fax Number
BANK REFERENCE
Name of Bank
 Contact at Bank
Address
 City
State/Locality
 Postal Code
Country
Phone Number
 Account #1
 Account #2
FACTORS & TRADE/CREDIT REFERENCES
Reference #1 (required)
 Account #
Address
 City
State/Locality
 Postal Code
Country
Phone Number
 Fax Number
Reference #2 (required)
 Account #
Address
 City
State/Locality
 Postal Code
Country
Phone Number
 Fax Number
Reference #3 (required)
 Account #
Address
 City
State/Locality
 Postal Code
Country
Phone Number
 Fax Number
Reference #4
 Account #
Address
 City
State/Locality
 Postal Code
Country
Phone Number
 Fax Number
MARKET
Have You Visited One Of Our Showrooms?   YES  NO 
Which Showroom? New York  Chicago  Minneapolis 
Atlanta  Los Angeles  Dallas 
What Type Of Showroom Was It?   Gift  Apparel 
PERSONAL STUFF
What Trade Shows Do You Attend? ASR  NY Int'l Gift 
Magic  Camex 
Surf Expo  Don't Get Out Much 
MERCHANDISE PROFILE
What Other Name Brands Does Your Store Carry?
Please List Other Brands Carried In Order Of Volume Sales
(Please make sure that your total for the following boxes totals 100%)		 Apparel  %
Accessories  %
Customer Profile
(Please make sure that your total for the following boxes totals 100%)		 Male  %
Female  %
If you have several store locations, please list them and their addresses below:
ADDITIONAL INFORMATION
Please include any other information which you feel is necessary
By submitting this form, you are giving David & Goliath authorization to verify Bank Information and check all trade/credit references above mentioned.