Application Form - Queen of Stitching

Application Form

Legal Business Name: *

DBA (if applicable):

Type of Ownership: *

In business since: *

Resale License Number: *

Product used for: *

Business Use
Resale

User Name *

Owner/Manager's Name: *

First

Last

Phone: *

Website / URL: *

Email: *

Email

Confirm Email

Address: *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Submitted By Name: *

First

Last

Signature

Title:

Date