Sublimagic Client Registration

Please complete the form below.

As a wholesaler/manufacturer we must have reseller certification information to sell products to our customers in the United States.

Please fill out the form below - we will process and respond within a few business days.

We may contact you via e-mail and/or phone to confirm information. Upon verification of necessary information the username/password you provide below will be activated.

Sincerely,
Operations/Sales

Company Name*
Contact Name*
Address 1*
Address 2
City*
State*
Postal/Zip code*
	Phone number
Business*
FAX
Other
E-mail address*
	(Optional) Your website address.

	Reseller #*

	Comments

	Desired Username (if duplicate exists your e-mail address will be assigned)

	Password (minimum 6 characters/numbers)

Fields marked with an asterisk (*) are required.