Partnerships

Untitled Document
BUSINESS PARTNERSHIP REQUEST FORM

We welcome our existing customers to become Preferred Business Partners and receive additional discounts based on your monthly volume purchases.  Please complete this form and submit it for approval to be a Preferred Business Partner.  Once approved, your account will be upgraded to the respective Preferred Business Partnership level and a new temporary password will be generated and set to you.

Company Name * :
Type Company : Corporation
LLC
Partnership
Sole Proprietorship
Type of Enterprise :
   
   
Monthly Partnership Purchase Commitment Level:
(Must constantly maintain monthly purchase levels to retain discount level)
Silver Partner  ($2,501 - $5,000    5% Additional Discount)
Gold Partner   ($5,001 -  $7,500   10% Additional Discount)
Elite Partner    ($7,501+               15% Additional Discount)
   
Individual Requesting Partnership Approval:
Prefix :
Name * :
Title/Position * :
Contact Address * :
City *: State *: Zip *:
 
Contact Information:
   
Office/Work Phone * : Ext.
Cell Phone :
Email Address *:
   
Best Time to Call during Business Hours:
AM PM Anytime

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