All information collected on this form is used for the sole purpose of
conducting business with your company, and is kept confidential.
However, we may disclose information as required by governmental
tax authorities. Also, when you order from our web site, we shall
disclose your billing information to our merchant processing bank so
that we may collect payment, and disclose your shipping information
to our shipping carrier so that you may receive your purchased items.
Please fill out the form completely so that we
may process your application.
After we have approved your completed application, you
will receive an email with your account information and
instruction regarding accessing your account and making your
first order. We appreciate your business. Thank You!