Become a
Retailer

Please take a minute to fill out the following form.
Remember to hit "submit" when you are done.
It will be automatically e-mailed to us and we
will send you our full line catalog
and wholesale price list.

 

Store name:
Phone Number:
Your Fist Name:
Fax Number:
Last Name:
E-mail Address:
Store Address:
Mailing Address:
City:
City:
State:
State:
Zip Code:
Zip Code:
Credit References:
(Please list 3)
Resale Tax Number:
Prodyne Customer Number:
What best describes
Number of Employees:
Your Business:
1-5
Retail Store
6-15
Export / Import
15-25
Distributor
over 25
Corporate Buyer
Years In Business
Promotional
1-5
Other
6-15
15-25
over 25

 

...................................menu..............................................ccontact us