In order to become a reseller, we need the following information:

Main Web Address:

Sub Page URL: (where books will be advertised)

Sub Page URL:

Company Name:

Contact Name:

Contact Title:

Company Address:

City, State, Zip:

Phone:

Fax:

Primary Email Address:

Secondary Email Address:

Address to mail payments to if different than above:

Company Name:

Contact Name:

Address:

City, State, Zip:

Comments:

Click to clear form.

Click to send application.

Please remember: before we can approve your application we need you to print, sign, and fax/mail our Reseller Agreement.