Signup Code (If Available)
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Company Name
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Billing Street Address or P.O. Box
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Billing City
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Billing State
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Billing Zip Code
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Shipping Address
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Same as Billing Address
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Shipping Street Address
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Shipping City
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Shipping State
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Shipping Zip Code
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Company Contact
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Company Contact Telephone
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Company Fax
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Company Contact E-mail
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Below, type an 8-Digit Password which your company will use to login to the Dealer Control Panel.
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Please indicate where your company will sell Captain Sports products. (Please select all that apply)
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Physical Retail Store(s) or Medical Location
Retail Store Name(s) and Zip Code(s)
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Internet Store
Internet Site URL
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Catalog or Mail Order
Catalog Name
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Other
Please Describe Below
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If your company will be submitting Dropship Orders, (orders sent directly to your customer from Captain Sports) we will send your customers a packing slip with shipment which includes your company name and/or store name and your company's contact information. Please complete the fields below to customize your Packing Slips.
If this section does not apply to your company, please continue to the next section.
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Header (Company, Website or Catalog name)
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Line 2 - Optional (Slogan, Sales Ad, Sales Offer)
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Customer Service Telephone
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Customer Service E-mail
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Years in Business
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Number of Employees
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If your company would like to be invoiced with shipment when ordering Bulk Orders (Inventory Holding Dealers) please check the "Invoice with Shipment" option and complete the brief Credit Application below.
Invoice with Shipment (Bulk Orders Only)
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If your company will pay for orders by credit card, please check the "Pay by Credit Card" option below and skip the following Credit Application.
Note: A credit card must be on file for dealers who will place dropship orders.
Pay by Credit Card
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If your company would like to be invoiced for bulk orders (Inventory) and pay by credit card for dropship orders, please check this option and complete the brief Credit Application below.
Invoice (Bulk Orders) and Pay by Credit Card (Dropship)
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Credit Card Paying Dealers:
After logging-in to your Dealer Control Panel please submit your credit card information by accessing the "Update Account Information" section.
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Invoice with Shipment Dealers:
Please complete the brief Credit Application below.
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Parent Company Name (If different than above)
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Company Formation
Corporation
General Partnership
Limited Partnership
LLC
Sole Proprietorship
Other
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State where company was organized
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Federal Tax ID or Social Security Number
