Credit Application: Company Check -- COD

LEGAL NAME OF BUSINESS: _____________________________________________________________

STREET ADDRESS: _____________________________________________________________________

CITY, STATE, ZIP CODE: ______________________________________________________________

BUSINESS PHONE: (      ) __________________________________
	
RESIDENTIAL PHONE: (       ) ______________________________

TYPE OF ORGANIZATION: (  ) CORPORATION (  ) PARTNERSHIP (  ) PROPRIETORSHIP

OWNER/PRESIDENT:_______________________________ SOCIAL SECURITY #:__________________

HOME ADDRESS:_______________________________________________________________________

HOME PHONE: (      ) _________________________________	

PARTNER/VICE PRESIDENT: _________________________  SOCIAL SECURITY #:_______________
                                                             
HOME ADDRESS: ______________________________________________________________________

HOME PHONE: (      )_________________________________  

BUSINESS ESTABLISHED (DATE) ___________ NO. OF EMPLOYEES _______ 

YEARS AT THIS LOCATION _________________

MAIN PRODUCTS SOLD ______________________________ GROSS SALES PER YEAR _____________                                                                                  	GROSS SALES PER YEAR                                      

Please Provide Three (3) Screen-Printing Supply References Who Accept Your COD 
Company Check:

(1) NAME _________________________________________ ACCT # __________________________

ADDRESS  _________________________________________ PHONE # (   ) ___________________

CITY     ________________ STATE ____ ZIP CODE ____ FAX # (   ) _____________________


(2) NAME _________________________________________ ACCT # __________________________

ADDRESS  _________________________________________ PHONE # (   ) ___________________

CITY     ________________ STATE ____ ZIP CODE ____ FAX # (   ) _____________________


(3) NAME _________________________________________ ACCT # __________________________

ADDRESS  _________________________________________ PHONE # (   ) ___________________

CITY     ________________ STATE ____ ZIP CODE ____ FAX # (   ) _____________________


BANK REFERENCES

(1) NAME _________________________________________ PHONE # _________________________

ADDRESS  _________________________________________ TYPE OF ACCOUNT _________________

CITY     ________________ STATE ____ ZIP CODE ____ ACCT # (   ) ____________________


(2) NAME _________________________________________ PHONE # _________________________

ADDRESS  _________________________________________ TYPE OF ACCOUNT _________________

CITY     ________________ STATE ____ ZIP CODE ____ ACCT # (   ) ____________________


I certify that I am twenty-one (21) years of age or older.  I certify that the facts 
contained in this application are true and complete to the best of my knowledge.  I 
hereby authorize the investigation of all references listed above to obtain pertinent 
information and understand that any information obtained will be held in strictest 
confidence.  I authorize full release of information pertaining to my bank accounts 
currently or previously held with your organization.  My signature below authorizes 
full release of this information over the phone to Lawson Screen 
Products, Inc.

AUTHORIZED SIGNATURE _________________________________________ TITLE _______________

PRINT OR TYPE NAME ___________________________________________  DATE _______________

+ The Company, herein applying for credit, recognizes that Lawson Screen Products, Inc. 
has certain "Terms and Conditions" that apply to, and govern, all quotations and sales.

*  I understand that Lawson Screen Products, Inc. charges a service charge of 1 1/2% per 
month on past due invoices.  The Company, herein applying for credit, agrees to pay 
any service charges, if applicable, and all legal and collection costs, including 
reasonable attorney fees if necessary.


PERSONAL GUARANTY

I/We, ___________________________________  and  ____________________________________
                  (Name)                         (Spouse - if applicable)

residing at ______________________________________________ for and in consideration 

of Lawson Screen Products, Inc., extending at our request credit to 
____________________________________________________________________________________
                                  (Name of Company)
									
hereinafter referred to as the "Company", 
of which ______________________________________________ is _________________________                                               
					 (Name)				            	 (Title)
hereby personally guarantee to you payment at 5110 Penrose Street, St. Louis, Missouri, 
of any obligation of the Company and we hereby agree to bind ourselves to pay you on 
demand any sum which may become due to you by the Company whenever the Company may fail 
to do the same. It is understood that this guarantee shall be a continuing and irrevocable 
guaranty and indemnity for such indebtedness of the Company. We do hereby waive notice of 
default, non-payment and notice thereof and consent to any modification or renewal of 
the credit agreement hereby guaranteed.

SIGNATURES: ______________________________________  _____________________________________
                                                               (Print Name)    
            ______________________________________  _____________________________________
                       (Spouse)                                (Print Name)

Witness: _________________________________	Date: _______________