OP Loftbed Preferred Manufacturer Application

Print legibly! If your application is accepted the below information will appear
on our web site, on your business cards, flyers, and other materials.

Name: ____________________________________________________

Company Name: ___________________________________________

Address: __________________________________________________

City: _______________________ State: ______ Zip:_______________

Telephone: ________________________________________________

Email: _____________________________________________________

Web Site: ___________________________________________________

OP Loftbed Preferred Manufacturer Agreement

1. As an OP Loftbed Preferred Manufacturer, I agree to:

2. As an OP Loftbed Preferred Manufacturer, I agree NOT to:

3. Buy cashing my check, OP Loftbed agrees to:

4. Buy cashing my check, OP Loftbed agrees NOT to:

5. Violation of the terms listed above is grounds for immediate removal from the OP Loftbed Preferred Manufacturer program without refund.

I have read the above agreement, and agree to be bound by the terms set forth during the time that I am an OP Loftbed Preferred Manufacturer.

Name: (Printed): ______________________________________________

Signature: ___________________________________________________

Date: _______________________________________________________

I would like to apply for an extended territory greater than the standard 25 mile driving radius.
          __ 50 mile total driving radius (include an extra $25.00)
          __ 75 mile total driving radius (include an extra $50.00)
          __ 100 mile total driving radius (include an extra $75.00)

When you have completed this application, mail it along with your application fee* to:
OP Loftbed Company
Attn: Preferred Manufacturers
PO Box 573
Thomasville, NC 27361-0573

Please make checks payable to OP Loftbed Company.

* Application fee for new applicants is $125.00. Application fee for applicants renewing their Partnership is $50.00 (plus costs for any extended territory) if there has been no lapse in status. If your application is rejected for any reason, your check or money order will be returned to you.