Wholesale Registration Form

Login Information
Username*
E-mail*
Password* Minimum length of 8 characters.
Repeat Password*
Contact Info
First Name*
Last Name*
Agree to continue*
- I understand that I must be an authorized buyer for my store to continue.
Do not continue if you are solely Accounts Payable for your business. If you manage Buying and Accounts Payable you can continue.
- Billing Address
- Company Name*
- Address*
- Town / City*
- State / County*
- Postcode / Zip*
- Accounts Payable Email*
- Accounts Payable Phone*
- Ship to a different address?
- Shipping Address
- Company Name*
- Address*
- Town / City*
- State / County*
- Postcode / Zip*
File Uploads
Resale License is required to submit a wholesale application. Other documentation may be requested at a later time.
Resale License*Upload File Type: PDF, JPEG, JPG
EINUpload File Type: PDF, JPEG, JPG
Credit ReferencesUpload File Type: PDF, JPEG, JPG
Other Questions
Do you require lift gate service for palletized shipments?*
- Lift Gate NOT REQUIRED
- Lift Gate REQUIRED
- Contact Me
Do you have a dock to receive freight trucks for palletized orders?
Zip Code Search*
- Add my store(s)
- Do not add
- Contact me about this
Would you like your store(s) to be added to our website to show that you carry Eastern Metal Works Inc products in your store? When this feature goes live in 2020 visitors to this site will be able to search their area for stores that carry our products. We hope that this project will bring customers through your doors.
reCAPTCHA*

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