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trans1 IntegraShowerSystems trans1
Integra Dealers

Thank you for your interest in becoming
an Integra Shower Systems dealer!

Please complete the application form below.

Agreement and Application for Account or Credit Terms

For the purpose of obtaining merchandise from Integra Shower Systems, LLC (seller), the following statement is made by the applicant, intending that the seller should rely on the same as correct.
Terms and Conditions
Name of Applicant:
Trade Name (if any):
E-mail Address:
Phone Number:
Billing Address:
 
City:
State: Zip:
 
Shipping Address:
 
City:
State: Zip:
I/We prefer to recieve invoices via: Fax: Fax#:
  E-mail: E-mail Address:
 
Business Information:  
Type of Business:
Check all appropriate		 Fabricator: , Kitchen/Bath Dealer: , Distributor:
Design Showroom: , Architect: , Designer:
 
Business Classification: Sole Proprietorship: , Partnership: , Corporation:
LLC: , FIEN:
 
Contact Information:  
Contact for Payment:
Contact for Payment E-mail:
Contact for Orders:
Contact for Orders E-mail:
Purchases Subject to Sales Tax?
If no, you will be required
to provide resale certificate.		 Yes: , No:
 
Owners, Officers or Partners:  
Principal 1 Name:
Principal 1 Address:
 
Principal 1 City:
Principal 1 State: , Zip:
 
Principal 2 Name:
Principal 2 Address:
 
Principal 2 City:
Principal 2 State: , Zip:
 
Trade References: Please List Three Active Vendors
Name Vendor 1:
Address Vendor 1:
City Vendor 1:
State Vendor 1: Zip Vendor 1:
Phone Vendor 1:
Fax Vendor 1:
 
Name Vendor 2:
Address Vendor 2:
City Vendor 2:
State Vendor 2: Zip Vendor 2:
Phone Vendor 2:
Fax Vendor 2:
 
Name Vendor 3:
Address Vendor 3:
City Vendor 3:
State Vendor 3: Zip Vendor 3:
Phone Vendor 3:
Fax Vendor 3:
 
  I have read and agree with the terms and conditions of this application.