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Wholesale Registration


Wholesale Register Form

Basic Info

1

About Your Business

2

Disclaimer

3
Company Name
Title
First Name
Last Name
Email
Phone Number
Password
Confirm Password
Show Password

Address
Attach Business Document:(Please Attach Current Year Sales Tax Certificate)

How long have you been in business?
Where do you sell?

If you have a retail store, what is the address?
Are you currently listing products online?
Website URL:
Ebay Store:
Amazon Store:
Other:
Do you have any questions for the sales team as you get started? (optional)
Do you agree to the disclaimer?
Disclaimer

*Please note that a limited number of products have export and drop shipment restrictions. For further information, please contact your Sales Representative.

"I have read and agree to the Terms of Service provided by Benhalex Corp. I also attest that I am applying on behalf of a registered business and am able to provide proof of business via official document from a Local or City Government, State Department or the Federal Government.