PRI New Vendor Application

Thank you for your interest in becoming a PRI vendor! Simply fill out the form below and hit submit. Or, click here for a printable copy of the form, fill it out manually, and fax a completed copy to PRI at 888-811-0382. We will promptly review your application and respond to you within 2 business days. You can begin selling and ordering PRI products immediately after you are approved.

Business Informaion

Your Business Name:
Business or Retailer Tax ID:
Number of Years in Business:
Business Phone Number:
Business Email:
Business Fax Number:
Type of Business:
If Other, please describe:
Company Website:
Shipping Address (No PO Boxes Please):
Check here if billing address is same as shipping address
Billing Address:

Owner Information

Owner's Name
Phone Number:
Fax Number:
Alternate Contact Person (if any)

Business References

Company Name:
Contact Person:
Contact Number:
Company Name:
Contact Person:
Contact Number
If this is a new business, please provide the date that the business plans to open (mm/dd/yy)
Vendor rules:

    - There is a minimum initial order of $600. There is no minimum for future orders.

    - Until Vendor is given open credit status (30-day billing), the Vendor must prepay or pay by Credit Card on all orders before getting a shipment.

    - In order to qualify for open credit status, the Vendor must have had at least 12 months of proven steady business with PRI. Proven steady business is defined as at least 4 orders throughout the year.

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