Please provide the following contact information:

Name		Bank
Title		Bank address
Organization		City
Street Address		State
Address (cont.)		Phone
City		Account
State/Province
Zip/Postal Code
Home Phone
Work Phone
FAX
E-mail
URL
State Sales Tax Number		Fed ID
Trade References: (Do not use manufacturers of clubs, balls or shoes as references)
Name		Name
Phone		Phone
Account Number		Account Number
Name		Name
Phone		Phone
Account Number		Account Number
Payment is Due on the 10th of each month for the previous months purchases. I understand and agree that any past due amount will be charged  1.5% interest per month until the balance is paid. Any account that is past due will not be able to make additional purchases until the account has been brought up to date. In the event that payment is not made and this account is referred for collection, the undersigned understands and agrees to pay the cost of collection and all reasonable attorney fees and litigation costs. By:     ____________________________________________ Date___/___/___ Title:______________