If you are a retailer and you are interested in distributing our products, just fill out the question form below to allow us to open your business account. We will send you by mail a catalog with our price lists and program terms.

Company name:
Business address:
Town, province or state:
Zip Code:
Phone #:
Fax #:
E-Mail:
Person responsible for buying:
Phone #:
In Business since:
Type of business:
Partners or shareholders:  
1.
% Interest:
2.
% Interest:
Bank:
Phone #:
Fax #:
Branch:
Address:
Town, province or state:
Zip Code:
Account #:
 
Credit references: Fax #:
 
Person responsible for accounts payable:
 
QC Retailer: GST #:
QC Retailer: PST #:
CDN Retailer: GST #:
US Retailer: IRS #:

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