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New Year offer, Get 100% OFF Prep Services for Polaris & Can-Am, and 50% OFF Prep Services on orders above $3,000.

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Email Address *

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Business Information

Registered Company Name *

Doing Business As (DBA)

Contact Name *

WhatsApp Number *

Country of Registration *

Company Registered Address * Shipping Address *

Business Type & Operations Type of Business *

Online Seller Retail Store Wholesaler Distributor Importer/Exporter Brand Owner/Manufacturer Prep Center/3PL Agency/Account Manager Other

Estimated Monthly Purchasing Volume (USD) *

Under $5,000 $5,000–$25,000 $25,000–$100,000 $100,000–$250,000 Over $250,000

Years in Business *

Sales Channels Where do you sell? (Multi Select) *

Online Store Physical Retail Store Wholesale Amazon Walmart eBay TikTok Shop Shopify Etsy Target Plus Faire Shopee Lazada Noon Flipkart Facebook Marketplace Instagram Shop Other

Storefront Link / Seller ID * Website Link *

Shipping Preferences Shipping Destination Type *

Own Warehouse / Business Address Marketplace Fulfillment Center

Legal Business Documents

Upload official business registration documents for verification. Supported formats: PDF, JPG, PNG. Minimum one document is required *

Declarations & Compliance

I hereby confirm that all information, documents, and representations submitted are accurate, complete, and authentic. I hereby acknowledge and agree to comply with all policies of Affirma Distributors. I understand that Affirma Distributors reserves the right to request additional verification, documentation, or clarification at its sole discretion. I authorize Affirma Distributors to verify submitted information, including contacting references, suppliers, or third parties, without prior notice if required.

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AFFIRMA DISTRIBUTORS

Email: Wholesale@affirmadistributors.us
Direct Line: +1 516 244 3318
What's App: +1 (518) 941-0723
Monday–Friday, 9 AM–5 PM (EST)

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