Store Application

Your Name:		Mr. Ms. Mrs. Dr.
Your Email:
Your Phone:		()
Store Name:
Address:
City, State/Province ZIP:		, Select One AK AL AR AZ CA CO CT DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SD SC TN TX UT VA VT WA WI WV WY Other ------------------------------- Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory
Country:		Select One USA Canada Mexico Other
Calif Resale#, if any:
Sales Type:		Storefront Home Based Online Other (explain below)
Vertical Focus: (if any)		Apartment & Condominium Managers Artisans Campgrounds Chess Clubs Chess Players Contractors Cruise Ships Decorators Federal Sector Golf Courses Home Owners Hotel & Resort Managers Park & Rec Managers Party/Event Planners & Equipment Renters Photographers & Prop Managers Schools Shopping Malls Trophy Makers Other (explain below) All (no vertical focus)
Geographic Focus: (if any)		My Town My Area (explain below) My County My State / Province Nationwide International Other (explain below)
Store Description:
Website: (if any)
MegaChess Displays to Purchase:
How You Will Sell MegaChess:
Photo of Storefront:		(jpg file)
Comment or Question: (if any)
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