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Retailer Account Application

Lone Star Pet Supply charges a $50 application fee to be refunded in the form of a credit with the first $500 minimum order.
Fee may be paid by credit card or money order.

Please fill in the form completely to expedite processing.
Your Name:
  We may wish to contact you for additional information about your application.
Please provide a valid email address below.
Your Email Address:
Store Name:
Street Address:
Store City:
  State:   Zip:
  Mailing Address (if different from above)
Mailing Address:
Mailing City:
  State:   Zip:
   
Store Main Phone #:
Fax #:
Sales Tax Permit Number:
  Copy of Sales Tax Permit needs to be mailed or faxed to Lone Star.
Owner(s) First Name:
  Last Name:
Owner's Home Address:
Owner's City:
  State:   Zip:
Owner's Home Phone #:
Owner's Cell #:
Check Writer's First Name:
  Last Name:
Check Writer's Drivers Lic.#:
  State:   DOB:
  2nd Check Writer's Information (Optional)
2nd Check Writer's First Name:
   Last Name:
2nd Check Writer's Drivers Lic.#:
  State:   DOB:
1st Contact Name:
(Optional) 2nd Contact Name:
Contact Methods:
Two pet industry references:
  Please include names
& phone numbers.
Do you have a
retail store with signage?:
Size of Store (sq. ft.):
Number of Employees:
Store Hours:
Store Image:
  Please provide .jpg picture of storefront and signage.
We do not deliver to Residential Areas.
P/O Required?:
Fax Invoices?:
Email Invoices?:
Fax Statements?:
Email Statements?: