Become a Dealer - Classic Window Coverings

Sales Tax Identification (Federal ID#)(Required)

Include dash

Company Name(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Fax(Required)

Please enter a number greater than or equal to 0.

Email(Required)

Owners Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Bank Information

Bank Name(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Account #(Required)

Trade References

Name(Required)

First Last

Account #(Required)

Phone(Required)

Contact Person:(Required)

Trade Reference #2

Name

First Last

Account #

Phone

Contact Person:

Trade Reference #3

Name

First Last

Account #

Phone

Contact Person:

Certification of Information

The undersigned, individually and on behalf of the Company does certify that the above information has been submitted for the purpose of securing authorized dealership, and is true and accurate to the best of his/her knowledge.
In consideration Classic Window Coverings, Inc. extending future credit from time to time to the Debtor, and other valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Guarantor, personally guarantees the prompt, full and complete performance of any and all present and future duties, obligations and indebtedness (the “Debt”) due to the Lender by the Debtor.

Signature of individual as Guarantor(Required)

Driver's License #(Required)

Expires(Required)

State(Required)

Dealer Account #

(for CWC use only)