CUSTOMER INFORMATION Name: ______________________________________________________________ Business Name: ______________________________________________________ Billing Address: _______________________________________________________ Mailing Address: ______________________________________________________ Telephone: __________________________________________________________ Fax: ________________________________________________________________ Email: _______________________________________________________________  Web Address: ________________________________________________________ Shipping Information          Carrier: _________________________________________________________          Account#: _______________________________________________________          Account. Zip Code_________________________________________________ Credit Card Information     Name on Credit Card: ______________________________________________     Card #: _________________________________________________________     Expiration Date: __________________________________________________ Have you worked with any other private label company? _______________________     If yes, what company? _____________________________________________ Do you have your own pattern maker? _____________________________________     If yes, please provide contact information. ______________________________ Do you have a spec’ sheet or a tech pack for the pieces you intend to produce? _____ How many styles do you anticipate producing? _______________________________ What are the numbers of pieces/styles/colors? _______________________________ Are you a (Circle all that apply.) Startup Business - Established Company - Store Owner – Wholesaler Manufacturer - Web Business - other ___________ Do you have fabric sources for the pieces you intend to produce? ________________ Do you have samples of the pieces you intend to produce? _____________________