Please complete the following form and return it to us.  All new accounts are on C.O.D. cash until your dealer application is returned.  Company checks will be accepted with your completed dealer application.

BUSINESS NAME: _________________________________________________________________
BUSINESS ADDRESS: ______________________________________________________________
BUSINESS PHONE #: (_______)____________________   FAX #: (________)___________________

STATE SALES TAX #: ____________________________    FEDERAL TAX #: ___________________

OWNERS NAME: _______________________________________   SS #: ______________________
OWNERS HOME ADDRESS: __________________________________________________________
OWNERS HOME PHONE #:  (________)___________________

OWNERS NAME: _______________________________________  SS #: _______________________
OWNERS HOME ADDRESS: ___________________________________________________________
OWNERS HOME PHONE #:  (________) ___________________

BANK CHECKING ACCOUNT: _________________________________________________________
BANK NAME AND ADDRESS: _________________________________________________________
BANK PHONE #:  (________) _________________________

Please list three trade references you have accounts with, include address and phone number.
(One must be a major distributor).

1 - _______________________________________________________________________________


2 - _______________________________________________________________________________


3 - _______________________________________________________________________________


Please include a picture of your store front, a copy of your telephone book listing, and a copy of your state tax certificate or license.

A $25.00 service charge will be added to all returned checks.

The undersigned applicant hereby gives written authorization to Wizzard High Performance, Inc., to contact the bank and credit references disclosed on this credit application, as well as credit bureau and/or credit reporting agencies and to obtain from such entities information Wizzard deems necessary to enable it to evaluate this credit application.

Applicant's signature attests financial responsibility, ability and willingness to pay our invoices in accordance with our terms.   I/We hereby agree in the event of default, to pay any reasonable collection cost and in the event the account is referred to an attorney, reasonable attorney's fees and costs.  That the venue for legal action may be placed in the county and state from which the goods are purchased.

Signature _____________________________________________________ Date _______________

Signature _____________________________________________________ Date _______________

Please complete the following information so we can service you better (it has no effect on your dealer status).

Do you have an H.O.  scale track in you shop? Yes ______  No ______

If yes please complete the following:

Type of track: Plastic -- Tyco -- Tomy -- Life-Like  -- Other ___________________________________

Commercial -- Manufacturer ______________________________   Rail height _________________

Table size _________________________________

Type of power 18 volt battery/Other _____________________________________________________

Road Course/Oval Longest straightaway _________________________________________________

Are you a member of any H.O./hobby organizations: (i.e. TOA, UFHORA, NRHSA) Yes ______ No _____

Please List: ________________________________________________________________________


Thank You! - Wizzard High Performance, Inc.