Long Beach Dive - Distributor Accounts Page

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Reseller/Distributer Accounts

Existing Account Login

Distributer Account Access :

New Account Enrollment

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Reseller and Distributor Account Enrollment Process

If your company wishes to become a Long Beach Dive product Reseller, or Distributor, we have provided our on-line credit application form below.

Once approved, you will be issued a Distributors password for on-line access to our volume discount pricing and ordering system.

After completing the on-line form below, your password will be e-mailed to the address specified on the form within 48 hours. A fax number will also be provided to send Long Beach Dive a signed copy of the Distributors agreement.

Distributor Agreements

For your convenience we have provided copies of our Domestic and International Distributors Agreements to the right.

A signed distributors agreement must be on file at Long Beach Dive before discounted pricing can be applied to your order.

You must complete the On-Line Reseller Credit Application and be approved by Long Beach Dive staff prior to submitting a signed copy of these agreements.

If your company would like to sell Long Beach Dive products in the United States and its territories, please use the following domestic form:

Domestic (USA) Distributors Agreement (PDF)

If your company would like to sell Long Beach Dive products outside of the United States and its territories, please use the following international form:

International Distributors Agreement (PDF)

Reseller / Distributor Account Request Form

Please complete and submit the form below to apply for a Long Beach Dive Reseller / Distributor account.

If you qualify for an account you will be notified by e-mail within 48 hours of submitting this form. You will then need to download and print one of the Distributor agreements and FAX it to the Long Beach Dive Sales office.
A password will be e-mailed to you separately for access to our Distributor's page.

(Fields marked with an asterix (*) must be completed in order to be considered for an account.)

Your Name:*

Title:*
Phone Number:*	Ext:
Fax Number:
Email Address:*

Business Name:*
Billing Address:*


City: *
State/Province: *
Zip/Postal Code:*
Country:*

Branch	Corporation
Partnership	Division
Proprietorship	Subsidiary

If you're business is a subsidiary, please the complete the following fields:
Subsidiary Of:
Address:


City:
State/Province:
Zip/Postal Code:
Country:

Line of Business: *
Other Trade Names:
Manufacturer	Wholesaler
Retailer	Other
Number of Employees:
Net Worth:
Estimated Annual Sales:
Date Established:
Former Location:

Owner or Officers
Name: *
Title: *
Name:
Title:

Bank Reference
Account Number: *
Bank Name: *
Phone Number: *
Address: *


City: *
State/Province: *
Zip/Postal Code: *
Country: *

Trade Reference
Name:
Phone Number:
Address:


City:
State/Province:
Zip/Postal Code:
Country:

Estimated Yearly Ordering Requirements *

Individual(s) to Contact Regarding Payments
Name: *
Phone: *

Special Billing Instructions:

Tax Exempt Status (Call the Long Beach Dive Sales Office and arrange to FAX your tax exemption certificate to our office.)

Credit Contract

By clicking on submit it is agreed that if a Long Beach Dive account is extended to my organization, payments* will be tendered in accordance with Long Beach Dive's selling terms of Net 30 Days. Each invoice is subject to a Finance Charge at the current percentage rate according to NY State regulations if not paid within 30 days.

* Full payment is required for all first-time orders.