*Company Name: 

*Address: 

*City:    *State/Prov.:    *Zip:

Country:

Email Address:

 Tax I.D.#:

*Account Contact:

Account Contact Email:

Buyer's Name: 

Buyer's Email:

Web Address (if applicable):

Date of  business establishment?

Do you have a showroom floor?: Yes   No

Do you sell via the internet?  Yes   No

Please describe your type of business:

TERMS & CONDITIONS

New dealers of GooseView™ Industries/Hill Outdoors™ may become authorized by filling out this application and faxing back a letterhead and resale tax certificate.  Terms are company check, money order, or credit card due prior to shipment. (We accept Visa, MasterCard, and Discover) After the dealer's combined purchases are equal to or greater than $2,500 the dealer may elect to apply for credit terms. If so, a credit application will be sent upon request . Terms are 15 days on approved accounts. Existing dealers will be maintained as authorized dealers provided that prior year's purchases meet the minimum order requirements. Please keep a current credit card on file for all purchases under $1,500 and any required drop shipments. Thank you.

By initialing and submitting this form I understand, agree, and will abide by the above conditions and terms of GooseView™ Industries / Deer River™, Hill Outdoors™, FarmLand™ Camouflage and Glacier™ Ice Shelters.

Initials:

Full Name: 

Comments or other requests: