Print Out Form

Select One:

____ YES, I'd like to be a Dealer Member of WHACO!

• Listing on the DEALER Page (www.whaco.com/deal.htm), including e-mail and homepage addresses
• Hotlinks to your primary web page and email address, if you have them
• User name and password access to the WHACO! Database,
• Forwarding of e-mail queries receive by WHACO! that relate to your specialty, if you have an e-mail account

PRINT NAME

______________________________________________________

DEALERSHIP NAME (If different)

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MAILING ADDRESS

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CITY__________________________________

STATE___________ZIP CODE____________

PHONE:_____________________FAX:_____________________

E-mail ADDRESS

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HOMEPAGE URL

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SPECIALIZING IN

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WHACO!
P.O. BOX 2428
SPRINGFIRLD, VA.
22152-2428