Please fill out the form below to become a distributor.
(you do not need to become a distributor if you want to buy at our
normal discounted pricing, only for wholesale pricing you do)
Name
Company name
Company Address
Website
Email address
tax resale number (only if you are in my state)
Are you tax exempt in your state?
What is your interest in promoting our products
How did you hear about Discount Detox
* Please note our discounts and wholesale prices are not good with any other offer or sale, purchase, or gift card or with promotional items, shipping fees or any other items not listed on our site.
(this is required by certain manufacturer's products we distribute)
You do not have to provide this unless we need it.
Please provide 2 of the documents along with your signed application form
current business license
state professional license
w9, Federal ID form or EIN form
business ID number
resale or tax certificate