Wholesale Application Form

I'd like to open a new account so I can do business with RGUI already have an account and need to place a reorderI have a customer service issue or requestI would like to become an authorized RGU distributor, wholesaler, or sales rep
Business/Store Name
Authorized Buyer Name *

First NameLast Name
E-mail*
example@example.com
Cell Phone Number*
Format: (000) 000-0000.
eCommerceBrick & Mortar LocationBoth
What is your NAICS or SIC code?
NAICS codes are 6 digits and SIC codes are 4 (i.e., 459420 for Gift, Novelty, and Souvenir Retailers)
Saw our products in a storeReferralTradeshowMagazine or Print ad (SGN)Magazine or Print ad (Seaside Retailer)Online Search (Google, Bing, etc.)Social mediaOther
Website URL*
Yes. I will provide a valid tax exemption certificate to buy tax free.Yes, but I'm in a state that doesn't charge sales tax.Yes. I am a non-profit and can provide a valid 503(c) to buy tax free.Yes, but I don't have a valid tax exemption and need to pay sales tax for my orders.No. I plan to give the product away.
Enter your sales tax exemption certificate #
Pursuant to N.C. Gen. Stat. § G.S. 105-164.28, we are required to obtain this to sell to you without charging sales tax. Please have a copy ready to provide to us so we can include it with your new account. If you need a copy, you may download and print one at www.theRGUgroup.com/resources
UPS or FedEx Shipping Account #
If you would like us to bill your corporate account, enter your UPS/FedEx account number. If not, leave blank.
Shipping Address*

Street Address Line 1

Street Address Line 2

CityState

Zip Code
YesNo
Billing Address

Street Address

Street Address Line 2

CityState

Zip Code
I’ll prepay all my orders with a credit card (Prepayment is required onthe initial order)I would like to apply for credit termsOther
Message*
By signing here, I swear or affirm that the information on this form is true and correct as to every material matter.

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Please verify that you are human*
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