Please fill out the simple form below and we will contact you within 24 hrs. with details and prices for becoming an official Black Pearl Cast Nets dealer. Thank you.

Distributor/Dealer Application

Business Name: Contact Name: Business Address: Business Address: City: State: Zip Code: Telephone Number: FAX Number: Email Address: Website Address:

Credit Card Information Visa:     MasterCard: Card #: Expiration Date:

Reference #1 Name of business: Contact Name: Business Address: City: State: Zip Code: Telephone Number: FAX Number: Reference #2 Name of business: Contact Name: Business Address: City: State: Zipcode: Telephone Number: FAX Number:

Additional Information:

Are you interested in becoming a Distributor: Dealer: If you want to be a distributor, How many retailers do you sell to?: What products does your business sell: Fishing Tackle:    Boats:    Bait: Other: How long have you been in business: yrs. Does your business currently carry other brands of cast nets?   Yes:No: If yes, what brand? Approximate number of cast nets do you normally sell in one month? Additional Comments or Requests: