Wholesale Account Application If you are human, leave this field blank. How did you hear about VISISCREEN? * Web search On the House Media DIY Network Social Media Trade Show/Association Other (please specify below) Other Referral Source If "other" option was selected above, please specify the referral source. Company Name * Enter the name of your company Contact * Enter the full name of your designated contact person Email Address * Enter the email address of your designated contact person Phone Number * Enter your contact person's phone number Company Address * The street, city, state and zip code of your primary business location Country * Country your business is located in Shipping address Country Shipped To Country orders will be shipped to Use Company Address for Shipping Same as company address Type of Business * OEM Distributor Retail Store Online Reseller Contractor Other Type of Business Description of Business * Briefly describe the nature of your business Resale Tax Number or EIN Number * Trade References Please provide three references of businesses from which you currently purchase wholesale. Include the business' name, complete address, as well as your contact's name, phone number, fax number and email address.
If you do not currently have three trade references, then please provide those you have and include additional information that would be helpful to establish your eligibility to qualify for a wholesale account with Aedes Technologies.
All information given to Aedes Technologies is kept confidential other than us contacting your bank and references.
Trade Reference #1 * Trade Reference #2 * Trade Reference #3 * Preferred Terms * Electronic Funds Transfer (EFT) Company Credit Card Net 30 DaysCheck one of the above. If you are requesting either the EFT or Net 30 Days options, you will also need to provide a credit application. You may email your own credit sheet to [email protected], but we still require that an authorized person sign our copy and Exemption Certificate (Sales Tax Exemption form). APPLICATIONS SENT WITHOUT A COMPLETED CERTIFICATE OF EXEMPTION WILL NOT BE PROCESSED. Download our credit application and Sales Tax Exemption Form below, complete the appropriate sections and then email to [email protected]
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