Prospective Member Profile
Store Name
:
Owner/Contact
:
Address
:
City
:
State
:
Select One
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
ID
IN
IL
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NM
NV
NH
NJ
NY
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WY
Zip
:
Phone
:
Fax
:
E-Mail
:
Is Retailer Currently a
member of a Buying Group?
Yes
No
Web Site
:
Current POS System:
Sales Information by SKU :
Yes
No
Internet Access
:
All Buyers
Single Access
Retail Volume
:
Yrs. in Business
:
Number of Retail Locations
:
Sq. Footage of Locations
:
Referred By
:
Nature of Retail Business
:
Select all that apply:
Hunting Sports
Luggage
Fishing/Tackle
HomeWorld
[Domestics\Housewares]
Outdoor/Camping
Hardware
Marine
Men's Clothing
Lawn/Garden/Patio
Women's Clothing
Outdoor Footwear
Children's Clothing
Athletic Equipment
Toys/Seasonal