NEW DEALER APPLICATION FORM Page 2 of 2

PRINT This Page (2) and Page 1. Fill them out. Sign, and fax to 905 564-4956!!

REFERENCES:
Complete information will speed up processing of your account.
Do NOT use 800 or 888 numbers

1) Company: 
Name
__________________________________
Address   __________________________________
 
Phone #
(       )_____________________________
Fax #
(       )_______________________________

2) Company:
Name
__________________________________
Address   __________________________________
 
Phone #
(       )_____________________________
Fax #
(       )_______________________________

3) Company:
Name
__________________________________
Address   _________________________________
 
Phone #
(       )_____________________________
Fax #
(       )_______________________________

4) Bank:
Name
__________________________________
Address   __________________________________
 
Phone #
(       )_____________________________
Fax #
(       )_______________________________

AGREEMENT WITH AURORA ALPINE.

In consideration of AURORA ALPINE allowing us to purchase goods and services on credit, we agree to the following:
1) We will pay invoices from you per terms and conditions on the invoice.
2) We will pay a monthly service charge on all overdue accounts.
3) Payments will apply first to service charges and then to the balance.
4) Ownership of any goods sold on credit shall remain with AURORA MARINE until paid in full.
5) We consent to your making a credit investigation and/or obtaining credit reports.

Applicant
Signature:
________________________________________		 Guarantee
Signature:
________________________________________
Name:
(Please Print)
________________________________________		 Name:
(Please Print)
_____________________________/__________
  Authorized signature Person responsible for payment (This constitutes a guarantee by the person signing to pay for any unpaid balance on this account)
Title: ________________________________________

Financial Statement Attached: [ ] (Will speed up processing of account)
Application will not be processed unless both Applicant Signature and Guarantee Signature appear above.

____________________________________________________________________________________________________
(FOR OFFICE USE ONLY)


Date: ____________________________________________

Limit: ____________________________________________

Manager’s Approval: _______________________________
Type of Account: ___________________________________

Sales Representative: ________________________________

Rejected by: _______________________________________

It is the policy of this company to sell only to marine and snowmobile dealers, service facilities, boat yards, boat and snowmobile manufacturers, or other marine and snowmobile oriented businesses.

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