Stacey's Bookstore Commercial Account Application (Please print clearly) When complete, fax to 415-777-5017: Attention Stacey's Accounts Receivable. Company Data _______________________________________________________________________________ Company Name _______________________________________________________________________________ Address                                                            City                    State          Zip _______________________________________________________________________________ Phone                                      Fax                               email _______________________________________________________________________________ Type of Business Billing Address (if different) _______________________________________________________________________________ Company Name _______________________________________________________________________________ Address                                                            City                    State          Zip _______________________________________________________________________________ Phone                                      Fax                               email Bank Reference _______________________________________________________________________________ Name _______________________________________________________________________________ Address                                                            City                    State          Zip _______________________________________________________________________________ Phone                                      Fax                               email _______________________________________________________________________________ Account Number Commercial References (2) _______________________________________________________________________________ 1. Name _______________________________________________________________________________ Address                                                            City                    State          Zip _______________________________________________________________________________ Phone _______________________________________________________________________________ 2. Name _______________________________________________________________________________ Address                                                            City                    State          Zip _______________________________________________________________________________ Phone Terms Account will be opened to qualified businesses or institutions only, not to individuals. Purchases can be charged only upon presentation of a valid card or company P.O. Payments due in full 30 days from purchase. Credit can be denied without notice if these terms are not met. Acceptance of Terms I authorize Stacey's Bookstores to contact the listed references solely to determine the credit history. _______________________________________________________________________________ By _______________________________________________________________________________ Title _______________________________________________________________________________ Signature _______________________________________________________________________________ Date What types of books are you and your company most interested in? _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ How did you hear about our corporate accounts program? _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________