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Oasis Detox Product Retailer

Become An Authorized Oasis Detox Product Retailer?

To become an authorized seller of Oasis Detox products, you must complete the wholesale products vendor application form below. The new accounts manager will contact you to discuss how we can best supply your online busines or retail store.



Name of Applicant
Contact eMail:
Fisical Address
                       
Billing Address:
                        
Phone # Fax #
Contact Name Tax I.D.
Number of Locations Years in Business
Names of Additional Persons Authorized to Place Orders:
Please list below three business references. Be sure to include name, phone number, fax number and contact person (Store buyer or Purchasing manager).
1.) Name
Address
Contact Person
Phone # Fax #
2.) Name
Address
Contact Person
Phone # Fax #
3.) Name
Address
Contact Person
Phone # Fax #
The above information is voluntarily provided to Oasis Detox Compalny & considered to be factual by the undersigned manager/owner.
Signature
Print Name
Title Date
   

    



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