Application for Wholesale & Distributor Price
Please fill out the form below and you will be contacted shortly.
*
Required fields.
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First Name:
*
Last Name
:
Title:
Buyers Name:
*
Company Name
:
*
Please select one:
Business Address
Residential Address
*
Address:
*
City
:
*
State:
*
Zip Code
:
*
Telephone:
Fax:
*
E-Mail:
Website Address:
*
Tax ID #
*
Resale Permit:
*
Business Type :
Please Select One
Screenprinter / Embroiderer
Ad Specialty Company
Licensed Wholesale Apparel
Import / Export
Uniform Company
Retail Resort Wear
Corporation Organization or School
Manufacturer
Retail Chain
Department Store
Boutique
Other:
*
Is this product intended to be decorated and then resold?
Yes
No
*
( Please select one ):
ASI
PPAI
SAGE
SAACNY
SAAC
None
Member #: