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 Back to Brensan Pattern Home            Back to Wholesale Information

New Account Information
for Wholesale Purchase of Patterns
Fax to:  360/326-1960
or Email to:  sales@brensan.com
Certificate of Exemption Form (also required)

Business Name __________________________________________________

Store Name (if different)___________________________________________

Contact:_________________________________ Title __________________

Email Address: (required for wholesale price list - Please print very clearly!

           ________________________________________________

Billing Address: 
____________________________________
____________________________________
____________________________________		 Shipping Address: 
____________________________________
____________________________________
____________________________________

Telephone ____________________________ Fax ___________________________________

SS# ______________________________ OR Fed ID# _____________________________

State Sales Tax #: ____________________________________

Name of Owner ____________________________________________________

Accounts Payable Contact if other than owner:

Name ________________________________ Tel ______________________________

Proprietorship: Yes No Partnership: Yes No Corporation Yes No

How Long in Business? ________________ How long at this address? _____________

Type of Store:     ___ Quilt Store ___ Fabric Store  ___ General Mercantile

Machine Dealership? ____________________________________

Special Interest Areas     ___ Workshops ___ Heirloom ___ Clothing Fabric ___ Wearable Art 
Other_____________________

 

 

 

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