If you are interested in becoming a authorized Leo's Dealer, please submit the information requested below. Once received, your application will be considered by our National Sales Manager and you will be contacted by one of our sales representatives.

New Account Application

Date:
Name of Business:
Store Address I: Store Address II:
City:	State:
ZIP:	Country:
Store Phone:	Store Fax:
Email Address:	www Address:
Store Owner/Manager:
How would you classify your business? Dancewear Shop Shoe Store Independent Shoe Store Independent/CHAIN Apparel Store Independent Apparel Store Independent/CHAIN Sporting Goods Store Department Store Department Store/CHAIN Ice Rink Pro Shop Gymnastic Pro Shop Catalog Company Dance Studio Bridal Shop Other
If other, please fill in.
Where did you hear about Leo’s Dancewear? Magazine Ad (Name of Magazine) Internet listing Referred by Received literature from Leo’s Trade Show Other
How long have you been in business? New Store:Opening Date Existing Store—Date Opened Former Account #		Type of Business? Individual Partnership Corporation Are you listed in D & B? Yes No Duns #
Are you affiliated with a dance studio in your area? Yes No
Note Field: