LINESHEET ACCESS FORM DOMESTIC AND INTERNATIONAL CUSTOMER APPROVAL FORM Date Brands ISABELLA TALYA CORPORATE NAME DBA NAME OWNERS NAME BUYERS NAME ADDRESS CITY STATE AND COUNTRY ZIP PHONE FAX EMAIL WEBSITE Type of Store (Check All That Apply) DEPARTMENT STOREINDEPENDENTBOUTIQUEMULTI STORE (4+)MAIL ORDERCLOSEOUTFOREIGNOTHER IF MORE THAN ONE STORE, PLEASE DISCLOSE COMPLETE STORE LISTING YEAR BUSINESS ESTABLISHED PRESENT LOCATION SINCE ARE YOU CURRENTLY DOING BUSINESS WITH COLLEGERE? YesNo IF YOU ANSWERED YES, PLEASE LIST WHICH COLLEGERE DIVISION(S) COMPARABLE GOWN & ACCESSORY LINES YOU ARE CURRENTLY DOING BUSINESS WITH NUMBER OF STORES YOU OPERATE LOCATION (PLEASE DISCLOSE ALL LOCATIONS) UPLOAD STORE PHOTOS (Minimum 3, up to 5) Required: 1 of the store front, 2 of the interior. Additional images optional. STORE FRONT PICTURE INTERIOR PICTURE 1 INTERIOR PICTURE 2 ADDITIONAL PICTURE ADDITIONAL PICTURE