Become a Dealer

North American Dealer Account Application

First Name:

Last Name:

Email:

Verify Email:

Company:

Role/Title:

Address:

Address 2:

City:

Prov/State:

Country:

Postal/Zip:

Web Site:

Work Phone:

(

)

Ext.

Alternate Phone:

(

)

Ext.

Fax:

(

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How did you hear about Twist Conditioning Inc.’s Wholesale Program?
*
1000 characters max

Type of business:
*
500 characters max

Retail Businesses are sales tax exempt. What is your PST/HST Number?

What year was your company established? *

Number of employees: *

Number of years at your current address? *

How many locations do you have? *

Please describe your current location(s): (mall, main street, industrial area?)
*
1000 characters max

Size of retail space: (Square Feet) *

What Products are you most interested in?
*
1000 characters max

What other similar products do you currently offer?
*
1000 characters max

What is your market like, and who do you market to?
*
1000 characters max

Do you print a catalogue?
Yes No * If yes, how many do you print per year?

Do you sell merchandise via the internet?
Yes No *

Have you ever been involved in bankruptcy?
Yes No *

What were your annual product sales last year?
*

Are you willing to educate yourself, your staff and your customers on the benefits of our products?
Yes No *

By submitting this form, I agree that I have read and understood the Terms & Conditions.
AGREE DISAGREE *