Distributor Pricelist Access Password Request and Credit Application Form.

All fields marked* are required.

First name:*

 

Last name:*

 

Company:*

 

Web page:

Telephone:*

 

Cell phone:

Fax:

Email:

Address:*  
City:*  
State, province:*   Zip code:*    Country:    
Credit Application Form on orders of $1000 or more.
Please complete all fields marked *.
Year established:*   Number of staff:*          
Federal Tax ID:  
Resale # in CA:  

Trade reference #1:*

Company:*

Name:*

Telephone:*

 

Email:

 

Trade reference #2:*

Company:*

Name:*

Telephone:*

 

Email:

 

Trade reference #3:*

Company:*

Name:*

Telephone:*

 

Email:

 

Banking information:*

Bank name:*

 

Contact name:*

 

Telephone:*

 

Account number:*

 

Please indicate your most popular product lines;

 

Please tell us what you like most about our products;

 

 Signature:*

 

Please submit, print and sign this page and fax with a copy of resale license to:

818-897-2429. As an alternative, send it by snail mail to:

Snack Snob, 11212 Bradley Ave., Pacoima, Ca. 91331, U.S.A. attn. Sales.

Upon approval, we will send pricelist password within 24 to 48 hours.