Apply | Saint Cosi - Store Intake Form

Business Identity

Basic information about your business entity.

Legal Business Name *

DBA / Trade Name (if different)

Store Name (consumer-facing, if different)

Business Type *

Years in Business

EIN / Federal Tax ID *

SSN or ITIN (sole proprietors without EIN only)

Resale Number (from state certificate)

State(s) You Do Business In

Owner & Contact

Who runs the show and how we reach you.

Owner Full Name *

Owner Title

Additional Owners / Partners (names + titles)

Primary Contact Name (if different from owner)

Email Address * (checked daily)

Phone Number *

Fax Number (if applicable)

Preferred Contact Method

Call Text Email

Authorized Order Placers (anyone else who can place orders)

Store Location

Where your store is located and when it's open.

Street Address *

Suite / Unit (if applicable)

City *

State *

Zip Code *

Address Type

Commercial Residential

Hours Open Per Week

Store Hours

Store Type

How your business operates. Select all that apply.

Your Website URL

Other (describe any other channels)

Products & Operations

What you sell and how your store operates.

Other Categories

Specific Brands/Products You Want to Order

Business Description

Card Shows (if applicable)

% Sales In-Store

% Sales Online

Online Presence

Your website and social media profiles.

Website URL

eBay Username

Amazon Seller Name

Social Media URLs

Other Platforms

Organized Play Certifications

Which tournament programs is your store registered for?

Check the box if you're certified, then enter your Store ID.

Play! Pokemon

Yes

WPN (Magic: The Gathering)

Yes

Konami OTS (Yu-Gi-Oh!)

Yes

GEM (Flesh and Blood)

Yes

Bandai TCG+

Yes

Bushi-Navi (Vanguard / Weiss Schwarz)

Yes

Lorcana (Ravensburger)

Yes

Upper Deck Diamond Dealer

Yes

UGN (UniVersus)

Yes

Other Programs

Current Distribution & References

Your existing distributor relationships and banking info.

Distributors You Currently Purchase From

How Did You Hear About Saint Cosi?

Banking Information

Bank Name

Bank Branch / Location

Account Officer Name

Bank Phone Number

How Long Have You Banked There?

Trade References

Reference 1

Company Name

Contact Name

Phone

Account #

Reference 2

Company Name

Contact Name

Phone

Account #

Reference 3

Company Name

Contact Name

Phone

Account #

Payment Setup

How you'd like to pay for distributor orders.

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Your information is secure. Payment details are used only for setting up distributor accounts on your behalf. We never store or share your financial information beyond what's needed for your applications. If you'd prefer to provide this info by phone, leave this section blank and we'll call you.

Desired Payment Terms

Prepay COD Net 30

Payment on File

Most distributors require prepay for new accounts. You can skip this and provide by phone instead.

Name on Account

Billing Zip Code

Checking Account: Bank Name (for ACH payments)

Routing Number

Account Number

Prefer to handle payment info by phone? Leave these blank and we'll call you at the number you provided.