Book Publishers Credit Group

NACM BOOK PUBLISHERS CREDIT GROUP

APPLICATION FOR MEMBERSHIP

In order for us to ascertain your company qualifications for the Book Publishers Credit Group, please complete the following application and return it to:

NACM Tampa Inc.
PO Box 22827
Tampa, FL 33622

APPLICANT COMPANY NAME:

TELEPHONE:

EXT:

MAILING ADDRESS:

FAX NUMBER:

800 NUMBER :

E-mail Address:

CITY / ST / ZIP:

NAME(S) OF INDIVIDUAL(S) RESPONSIBLE FOR CREDIT FUNCTIONS AND WHO WILL ATTEND MEETINGS: (CREDIT MANAGER)

NAME:	TITLE:
	E-mail address:

TYPE OF BUSINESS:

YEAR ESTABLISHED:

ANNUAL SALES VOLUME:

AVERAGE NUMBER OF OPEN ACCOUNTS:

TYPE OF PRODUCTS SOLD:

AVERAGE OUTSTANDING BALANCE PER ACCOUNT:

SUBMITTED BY:

AUTHORIZED SIGNATURE & TITLE:

DATE:

Applicant understands the primary business of their organization must be original publishers of books; selling to wholesale or retail companies and/or distributor on a national basis and be able to make meaningful contribution on published clearances as well as discussion accounts, and abide by all provisions of the by-laws established by the Group. If so requested, the applicant would be agreeable to answer any questions concerning his eligibility for Group membership

Board of Directors Use Only
Date Reviewed:		Accepted/Rejected		Date Contacted: