New Wholesale Registration

 

Benjamin International is strictly a wholesale company.
Please fill out the information below. A Tax Identification Number is required for an account.


NEW CUSTOMER APPLICATIONS WILL BE
REVIEWED IN ONE BUSINESS DAY.


You will be notified by email that your account has been approved.



NOTE: Registrations placed after 6pm EST on Friday night will not be reviewed until Monday morning.
TitleFirst Name*Last Name*Suffix
Name
* Required Field
Title:
Company Name:
Company Phone Number:
Address 1:
Address 2:
City:
State:
Company Website:
Type of Retail Store:
Select Challenge Question and enter the response. This will be used if you forget your password.
Question:
Answer:*