DEALER CATALOG REQUEST and WEBSITE LOGIN APPLICATION



DEALER CATALOG REQUEST and WEBSITE LOGIN APPLICATION

Auburn Leathercrafters Phone 315-252-4107

42 Washington St. Orders 800-282-8761

Auburn, NY 13021-2496 Fax 315-252-4734

USA Website

See directions at bottom of page 2 E-mail sales@

CHECK to request catalog by mail CHECK to request LOGIN by e-mail

Without this completed form, an LOGIN account cannot be established. Date:      /     /     

Business Name:                                              

Mailing Address:                                              

City, State, Zip Code:                                              

(If different than Mail Address)

Shipping Address:                                              

City, State, Zip Code:                                              

Owners Name(s):                                              

Buyer Name(s):                                              

Telephone Number:      /     /      Alternative Phone:      /     /     

Cellular Number:      /     /      Fax Number:      /     /     

Do you operate a retail outlet from this location? Yes No

Web Site:                      E-Mail Address:                     

Federal ID Number:                                    

And or

Sales Tax or Resale License Number:                                    

Business Type: Check all that apply to your business:

| Full Line Pet Shop with Animals | Grooming Shop |

|Full Line Pet Shop without Animals |Feed Store |

|Pet Boutique Shop |Kennel Only |

|Gift Shop |Kennel with Retail Store |

|Mail Order |Super Pet Store |

|E-Commerce / Internet Store |Multi Unit Retailer (4 or more locations) |

|E-Bay Auction and/or Store |Dog Trainer |

|Mass Market |Veterinarian |

|Pet Walker / Pet Sitter |Grooming School |

|Humane / Pet Rescue Organization |Other (Describe)                      |

DEALER CATALOG REQUEST and WEBSITE LOGIN APPLICATION

Auburn Leathercrafters Phone 315-252-4107

42 Washington St. Orders 800-282-8761

Auburn, NY 13021-2496 Fax 315-252-4734

USA Website

See directions at bottom of page E-mail sales@

Pet Product Related Trade References:

List suppliers with whom you purchase merchandise from on a regular basis.

(1) Business Name:                                              

Mailing Address:                                              

City, State, Zip Code:                                              

Telephone Number:      /     /      Fax Number:      /     /     

(2) Business Name:                                              

Mailing Address:                                              

City, State, Zip Code:                                              

Telephone Number:      /     /      Fax Number:      /     /     

(3) Business Name:                                              

Mailing Address:                                              

City, State, Zip Code:                                              

Telephone Number:      /     /      Fax Number:      /     /     

Form Directions:

( Use the “tab” key to advance through the fields to enter data.

( Press “shift, tab” to go back one field.

( When completed:

( Press: “Alt-F”:

( Select: “Save As”

( Please enter the file name as: “LOGIN with your store name”

( Select: “Save

When completed, do one of the following:

( Email forms to: sales@ Attention: Sales Department - DEALER FORM

( Print form(s) and MAIL to: Auburn Leathercrafters

42 Washington St

Auburn, NY 13021

( Print form(s) and FAX to: 315-252-4734

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