1. Please provide the following contact information

           Business Name 

          Address             

          Address (cont)   

         City     State       Zip 

        Telephone          Fax     Web URL

    2. Business Information

        Federal Tax ID #           DUNS # 

        PA Sales Tax #  (Please forward a tax certificate)   

        Soc.Security #                      Number of Years in Business 

        Bank Name        Bank Account # 

        Address             Address (cont)    

        City                      State        Zip 

    3. Annual Volume: (Sales in Custom Window Treatments Only)

            Under $100,000     $100,000-250,000    $250,000-500,000    $500,000-1,000,000

    4.  I am interested in purchasing from Bishops, Inc.:                All Items Listed Below

            Drapery Fabrics/Sample Books                   Drapery Lining                                CONSO Trims/Claesson Hardware

            Workroom Services                                    Kirsch Hardware                            Custom Bedding

            Premier Brass Window Wear                      Kirsch Custom Hard Treatments   Hunter Douglas Shades

            Fabric Lamination

    5.    Please List Three Textile Trade References (No 800 Numbers)

        Supplier                    Account #   

        Address                   City             

         State                 Zip                   Phone         

                          ------------------------------------------------------------------------------------------------------------------

        Supplier                  Account #    

        Address                  City            

        State                  Zip                 Phone         

                         -------------------------------------------------------------------------------------------------------------------

       Supplier                  Account #       

        Address                   City               

        State                  Zip                 Phone           

                         --------------------------------------------------------------------------------------------------------------------

    6.  Select all the business types that apply:

	Workroom     Designer/Freelance   Designer with Design Group         Home Based

	Architect    Shop at Home         Furniture Store w/Drapery Dept.    Retail Store 

 	Other 

  7.  Owner's Information

  SIGNATURE ATTESTS FINANCIAL RESPONSIBILITY, ABILITY & WILLINGNESS TO PAY IN ACCORDANCE WITH TERMS.

  OWNERS NAME (Please print)

  HOME ADDRESS   CITY  

  STATE    ZIP               HOME PHONE  

  OWNER'S SIGNATURE    DATE  

  --------------------------------------------------------------------------------------------------------

	Referred or Heard About Bishops From: 

Please Note That Our Terms Are NET 30.  Failure to Comply Can Delay Shipments.

Thank You For Your Cooperation!  Any Questions?  Call us TOLL FREE: 1-888-4BISHOP (427-7467)

OR FAX Us Your Credit Application: 412-821-SHOP (7467)

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