The Trade Exchange, Maine

Application

If you wish to apply, please fill out the following form. All fields are required except those indicated with a *

Business Name:

* Corporation Name
(if different):

EIN or SS No.:

Address:

Address (cont):

City:

State:

Zip Code:

Telephone:

Mailing Address (if different):

*
*

* City:

* State:

* Zip Code:

* Telephone:

President/Owner:

* Fax:

* URL:

E-Mail:

Description of business (50 words or less):

Sole Proprietor Partnership Corporation

Product/Service Listing - Require at least one	ID Cards to Be Issued - Require at least one

Please provide the names and telephone numbers of at least 3 clients or customers you serve:

* Sponsor name:

* Your name:

* Your title:

Date:

* Additional comments or special requests:

By submitting this form you agree to have read and understand the rules outlined on this page