The Distributors Account Application Form

Bookseller Application Form ...

Shipping of your electronic book orders with The Distributors is absolutely free for the first month to enable you to really give us a good try.

Be sure to press the Send to The Distributors button at the bottom of this screen when you have completed the form.

Your Distributors userid	... enter your current id or choose a new one for yourself
Your Distributors password
Business Name
Contact Name
Specialties




Your e-mail address
Your Phone#
Your Fax#
Public Numbers?	...may we display your phone and fax numbers on the Web?
Address

Your City
Your State
Your Country
Zip Code
Currency	...in what currency do you price your books?
Affiliations (e.g. ABA)
What form is electronic order data currently in?	e.g. IBID, POETS, B&T, etc
How did you hear about us?
HomePage URL	... if you already have one
Your comments

04/01/2006 04:31:40 PM Eastern Daylight Time
Please direct questions, comments or problems to the Account Department .