New Customer Application

Please fill out all the necessary information to complete your new customer application. You must have a retail operation to order from Product Performers. Online stores must provide a live link to their website. Lastly, you must provide a copy of your resale license or tax ID. Incomplete applications will not receive a response from our new accounts department.

Company Name	*
Contact Name	*
Email Address	*
Phone Number	*
Fax Number
Type of retail operation	*	Brick & Mortar Online
Brief description of your company	*
Website Address (if applicable)
Billing Address	*
Shipping Address	*
Please attach a copy of your resale license or tax ID
If you will be faxing your resale license or tax ID to (847)808-7355, please specify here:		I will be faxing my business license or tax ID
Additional Comments