INSTRUCTIONS ...

1. Complete the form below and print the page.
2. Include a photocopy of your resale certificate.
3. If you wish to establish a Net 30 account, include a written notice of a bank reference, three trade references, and/or a D&B number.
4. Fax all of the above to 401-397-7062 or mail to:

All fields are required.

Bill To:

Contact Name
Company Name
Street Address
City	State      Zip
Country
Phone
E-Mail
Tax ID/Resale #

Ship to:

Same as "Bill To"
Contact Name
Company Name
Street Address
City	State       Zip
Country
Phone
Special Instructions

First order must be pre-paid with MasterCard/Visa or C.O.D. To establish a Net 30 account, be sure to include a written notice of a bank reference, three trade references, and/or a D&B number.

 Send my Account Number and Password by fax to:
 Send my Account Number and Password by e-mail to:

By submitting this form, the client certifies that he/she has read and agrees to abide by the Wholesale Terms published on this web site.