This is the Application Form to open an account with Mall-Central.com. No obligation.

Today's Date: 07/31/2010 Promo Code: Your Name: Store or Business Name: Address: Phone: Fax: Account Short Name: whatever you like such as a short and cute name that identifies your store. If you have multiple stores by the same name in multiple cities try the store nickname followed by the city. The shorter the better. At least three characters, though. All lowercase. Alphanumerics are OK starting with an alpha character. Is Your Store a(n): Please Select One Antique Mall Crafter's Mall Both Other How do you track your sales? Name of your POS: Please Select One AAIN FastTrack Anteq ComCash Homestead Mallease Falcon Mall Sales Manager Mallease Falcon MarketWare by Dymond Software Gallery The MallMaster Manual Other Don't Know POS System (other): Number of dealers in your store: Do you call your dealers: Please Select One Dealers Vendors Crafters Merchants Pricing depends on the number of Subscribers and the maximum number of transactions (items) the store sells per period (ie month). Your store may have many more Dealers than Subscribers (subscribers are dealers that want on-line access to their sales). Maximum Maximum Price Package Subscribers Items per month -------------- ------------- --------- --------- Plan B 25 5,000 Plan C 75 15,000 Plan D 150 30,000 Plan E 300 60,000 Plan F 600 120,000 All Plans except have a $50 set up fee. Monthly rates are not made public. Sorry. Please contact us for pricing. Plan: Please Select One Plan B 25 Subscribers Plan C 75 Subscribers Plan D 150 Subscribers Plan E 300 Subscribers Plan F 600 Subscribers Any Question?: How did you hear about us?: Please Contact me via: Please Select One Email Phone Phone or Email Please include your email address if you want us to contact you by email Email: Store email: (if different from above) Type "1234" here:

You make no committment by filling out this form.

You do not even have to fill it out completely.

Just give us enough information to help us contact you. We'll be happy to discuss and answer any other questions you may have about our service.