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Dropshippers / Home Based Business Fax / Mail Registration Form
The special "Trade Courtesy Discount" Offered to Dropshippers / Home Based Business is granted upon verification of your Business
Telephone Number, Federal Tax ID#, or Resale Certificate #. We will process your application promptly and reply to you with either result.
If approved, your permanent Trade Discount Password will be e-mailed or faxed to you. When submitting your reseller form please fill in the
relevant boxes below. Your information alone can greatly help us with your inquiry.

Company Information
 All information kept 100% confidential.

Company / Store Name : * Required
How long have you been active
in this business		 : year/s.
Company Address 1 : * Required
Company Address 2 (Suite#, Apt. #) :
City : * Required
State / Province : * Required
Zip Code : * Required
Country : * Required
Business Phone : * Required
Fax :  
What is your main products 1 : * Required
 2 :
Company Homepage :
Email Address 1 : * Required
Email Address 2 :
Owner's Name : * Required
Buyer / Contact Name : * Required
Federal Tax I.D.#
F.E.I.N. or
E.I. Number

 		 : *You Must Supply at least ONE of the following:
  Federal Employer Identification Number or Federal Tax ID Number is a nine digit number
   issued to each business by the IRS). It is also the number under which the business files its own
   taxes.
 
Resale Tax Certificate Number or
Sales and Use Tax Permit
 		 :
  The Sales Tax Permit is issued by the Board of Equalization or the Office of the Comptroller.
 
What Line of Products Do You
Interested In?		   : Teak Patio Furniture   Cast Aluminum Furniture   Rattan Outdoor Furniture
  Indoor Furniture   Console Table   Fireplace Mantels
  Kids Furniture    
     
Have you previously purchased from Anderson Furniture? : Yes          No
     
What kind of Business or
Store do you have?
 One only option allowed. Please select the best describe for your business. 		  Accent Furniture Antiques Furniture
Dec. Accessories Collectibles Garden Access.
Tabletop Lighting Floral
Wall Decor Gift Mail Order Catalog
   
How Do you Know Us?   : Search Engine    Website   Worldwide Brands
      Newspaper   Magazine   Friends
      Others    
   
        Explain About Your Business:

You may write us additional information
about your business that could help us to better evaluate your application.

  

         

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