Application for Wholesale / B2B Account

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Company Name*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Company Website

Resell Tax Exemption #*

Contact Name

First Last

Your Role*

Email*

Are You Able to Recieve LTL Shipments?

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Do you have a dock?

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No

What is your company presence:

How many years in business?

How do you plan to sell our products?

What kinds of products do you currently sell?

Please provide a brief history of your company?

Behrens Manufacturing prohibits selling our products on Amazon or other 3rd party marketplaces*

Our authorized wholesalers/retailers/representatives can sell and feature Behrens products on their own websites but are not allowed to resell Behrens products on 3rd party marketplaces such as Amazon, eBay, Walmart.com. We monitor 3rd party marketplaces and will block violators from purchasing with party, or you have further questions please contact us at 800-657-4939 or customerservice@behrensmfg.com. Thank you By clicking the box below, you agree to adhere to Behrens 3rd party selling policy.

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