12632 Sunset Avenue Ocean City, Maryland Telephone: 410-213-0680

APPLY FOR AN ATLANTIC SKATES ACCOUNT

NEW ACCOUNTS
Please fill out application. Send it to us. Upon receipt
of your information we will open our web site to you at
which time you can view and/or order. Your e-mail
address will be your user name and the password on your
application will be your private password. Any questions
e-mail [email protected].
You must have a State Resale Tax ID# (or Federal # for those states that do not charge sales tax). And you must have a complete e-mail address.


COMPANY INFORMATION


Company Name

Tax ID/SSN

Contact Person


ACCOUNT LOGIN INFORMATION


Email Address

Password

Re-Enter Password


BILLING INFORMATION


Name

Address Line 1

Address Line 2

City

State

Zipcode

Phone Number


SHIPPING INFORMATION


Same as Billing

Name

Address Line 1

Address Line 2

City

State

Zipcode

Phone Number


QUESTION / COMMENT




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