Wholesale Request Appplication

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Wholesale Application Password Request

The purpose of this form is to establish that you are qualified for wholesale pricing and status. We will respond within one business day. We ask you to establish your Name and Identity to allow us to identify you when you return. Once you are approved you will be able to navigate the site and decide whether or not to become a reseller and wholesale purchaser. Your access password will be sent to you in a separate e-mail which will permit you to see all wholesale pricing.

Privacy Statement and Policy

REQUIRED FIELDS HAVE AN ASTERISK *AND MUST BE COMPLETED

First Name *	required
Last Name *	required
Company Name *	required
Address *	required
City *	required
State or Province*	required if country
Postal Code-Zip *	required
Your Country *	required
Phone *	required
E-Mail *	required
Confirm E-Mail *	required
URL
Member Type *	required
Where did you hear about us?*	required
Approximately how many items do you sell now?*	required
What types of products do you currently sell?*	required
Does your company have A Tax ID Number?* Include It.	required
I am a new in business and need help.
I want exclusivity in my area and will make my first purchase of $5000.00
What year was your business founded?*	required
When will you begin ordering? Now, Next Week, In 30 days, In 3 Month's, Who knows*	required
Description of your Business and Goals*
Comments

Information on this site is provided for informational purposes and is not meant to substitute for the advice provided by your own physician or other medical professional. You should not use the information contained herein for diagnosing or treating a health problem or disease, or prescribing any medication. You should read carefully all product packaging. If you have or suspect that you have a medical problem, promptly contact your health care provider. Copyright and disclaimer ©2003-2008 Macaperu.com All rights reserved.

Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease.