eTropicalFish.Com
Supplier's Registration
   
 Account Info  
*Login:
*Password:
*Confirm Password:
*Company Name:
*E-mail:
*Phone (in format 999-555-5555):
*Fax:
 
 Owner Contact Info  
*First Name:
*Last Name:
*E-mail:
*Phone (in format 999-555-5555):
*Cell Phone (in international format):
*Home Phone:
*Fax:
Alternate Fax:
Web Site:
 
 Manager / Sales Person Contact Info  
   
*Title:  
*First Name:
*Last Name:
*E-mail:
*Phone (in format 999-555-5555):
*Cell Phone (in international format):
*Home Phone:
*Fax:
Home Fax:
 
 Emergency Contact Info  
*Contact Name:
*Phone: (in format 999-555-5555):
*Cell Phone (in international format):
*Fax:
 
 Company Address  
*Address:
*City:
State/Province:  
Zip Code:
*Country:  
 
 Billing Address  
   
*Address:
*City:
State/Province:  
Zip Code:
*Country:  
 
 Freight Forwarder (as it appears on your AWB)  
*Company Name:
*Address:
*City:
State/Province:  
Zip Code:
*Country:  
*Phone:
*Fax:
E-mail:
 
 Global Discounts  
PLANTS: %
AQUATIC PLANTS: %
WOOD: %
LIVE ROCK: %
SALT WATER: %
FRESH WATER: %
REPTILES: %
DRY GOODS: %
CORALS: %
 
 Special Discounts  
%  
 
Date Started During Business With CIS (in format mm/yyyy):
 
 Requested Payment Term  
 


 
  day(s)
 Questionnaire (optional)  
1. What are your strongest Categories of Tropical Fish & Marine Life you supply?  
 



 
2. What are the Markets do you currently Ship to?  
 


 
3. If you are shipping to the United States what States do you ship to the Most?  
 




 
4. Do you have any exclusive Contracts with any Buyers in a given Country?  
What Country?
What State?
 
5. How long has your Company been in Business?  
 
6. How long has the present Owner of the Company owned the Business?  
 

   

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