Purchase Application

Your Name*
First Last
Your Email*

Your email address.
Company Name*
What is the name of your company? Please use full legal name and trade name(s).
Company Phone Number*
Please enter the phone number for your company.
Address*
Street Address City State ZIP Code

Where is your business headquartered?
Type of Business*
What type of business are you in?
Business Entity*
- Corporation
- Partnership
- Proprietorship
State of Corporation
Please select the State where your business was Incorporated.
Number of Partners
Please select the number of Partners in your business.
Sales Tax Status*
Choose the tax status of your business.
How many years has your company been in business?*
Tell us how long your company has been in business
How many years have you been under the current management?
Everything stated in this application is true and correct. Applicant understands that Poolquip, Inc. may retain application whether or not it is approved. Applicant understands that the sole purpose for complething this form is to qualify the company to purchase materials from Poolquip, Inc. and that the purchased materials will be used in the comapny's pool business and not solely for the personal use of principals or their employees or friends.*
- I agree