Apply For Wholesale Account Please complete the following form and click the submit button. Your time is valuable to us. Many of our customers have multiple store locations. For your ordering convenience, our order system can track multiple store locations in your company profile. This is a time saver for our customers as the order system will pre-fill many of the order fields during the ordering process. Each store location will need to have a unique name (identifier). Most commonly this is a short description by which the store is known within your company like "Store 21" or "Dallas-West" for example. One initial store location (along with your user login account) will be created when this form is processed. When your account is approved by Campus I.D. you will be able to log into the order system and place orders. Additional store locations and user accounts can be added once you login to the system. Company/Customer Information Company or Customer Name Resale Tax ID Location Location Name Phone 1: Phone 2: Fax: Address Name Address 1 Address 2 City State AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip User Information First Name Last Name Email (Your email address will be your login id) Password: (4-10 characters, numbers and letters only) Confirm password: (4-10 characters, numbers and letters only)