Please print out this form and fax a completed copy to us.

Tinsley-Clark Co.
6 E. Burkwood Ct.
Jamestown, NC 27282
Toll Free: 1-800-255-2384
Email:  linens1@triad.rr.com
www.tclinens.com

WHOLESALE ACCOUNT APPLICATION

DATE______________________

BUSINESS NAME:___________________________________________________________________________

BUSINESS DESCRIPTION:______________________________________________________________

PHONE:______________________________________________

FAX:_____________________EMAIL:______________________

BILLING ADDRESS:_________________________________________________________________________

SHIPPING ADDRESS:_________________________________________________________________________

CITY/STATE/ZIP:_____________________________________________________________________________

FEDERAL TAX  ID# _________________________

BUSINESS STARTED:____________       OWNER/MANAGER:______________________________________

CREDIT CARD INFORMATION: (Not required to process application)

MC_____ VISA_____ DISCOVER_____

CARD #: _______________________________________________________EXP. DATE:_____/_____

CARD NAME:_________________________________________