Wholesale Registration

DISCLAIMER: US HOSE & COUPLING ONLY SELLS TO DISTRIBUTORS AND QUALIFIED OEM'S

* If you are not a distributor or an OEM, please click the button below and we will refer you to one *

WHOLESALE REGISTRATION

Username*

Email*

Password*

Confirm Password*

First Name *

Last Name *

Company *

Address line 1 *

Address line 2 (optional)(optional)

City*

Postcode / ZIP *

State / County or state code *

Phone *

Copy from billing address

First Name (optional)

Last Name (optional)

Company (optional)

Address line 1 (optional)

Address line 2 (optional)(optional)

City (optional)

Postcode / ZIP(optional)

State / County (optional)

Tax ID *

REQUIRED - Upload Tax Exemption Form(s) - TO ATTACH YOUR FILE, CLICK HERE --> *