Application for Distributor Pricing on Stock Products

For consideration as a distributor, you must provide all the following information below.

Distributor pricing is only granted by written approval from Michael Shaffer and is in effect for all purchases from the date of written approval. Special discounts only apply for some stock products.

As a general rule, you should request only one product group. Our experience shows that the most successful distributors are those who focus on the product group that is most likely to build sales quickly.

We initially invoice new distributors at the published internet prices. Then AFTER your company has acheived the minimum annual purchase requirement, we will rebate your company the agreed upon distributor discount on all purchases retroactive to the approval date as established by Michael Shaffer.

For new distributors, please allow 2 weeks for processing your request.

Please provide all the following information; we will not consider any applications with partial information:

Distributor Application Form

* denotes required fields

Name: *

Title: *

Company: *

Address Line 1: *

Address Line 2:

City: *

State/Province: *

Zip/Postal Code: *

Country *

Phone Number: *

Phone Extension:

Email Address *

Company Description: *

Customer Information: *

Market Information: *

Interested Products: *

Purchase Projections: *

Target Market:

Leave this field empty: