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 Ben Hogan Golf Collegiate Partner Information/Credit Application Primary Contact
Phone Number
Email Address
College/University
Federal ID #
Coach/Instructor
Email Address
Business Address
Phone Number
College / University Information Type of College or University (Choose One)
! State
! Private
Date Established
Division
! Junior College D&B D-U-N-S
State of Corp
Fed ID #
Athletic Conference
Business Address
Bill to Address
Phone Number
Ship to Address
Fax Number
Trade References (Please complete both trade references) Company Name
Company Name
Contact Name
Contact Name
Address
Address
Phone
Phone
I hereby certify that the information contained herein is complete and accurate. This information has been furnished with the understanding that it is to be used to determine the amount and conditions of the credit to be extended. Additional information may be requested if needed. Furthermore, I hereby authorize the financial institutions listed in this credit application to release necessary information to the company for which credit is being applied for in order to verify the information contained herein.
______________________________________________________________________________ Authorized Account Signature
Printed Name
Date
Ben Hogan Golf Equipment Company, LLC 685 John B. Sias Memorial Parkway, Ste 515 | Fort Worth, TX 76134 | 1-844-53Hogan
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www.BenHoganGolf.com