Dealer Enrollment Application from The Studio


Toll-Free Order Line: 1-888-437-8834

PLEASE NOTE:

All requests for consideration of enrollment
as a Zippo brand products wholesale dealer
MUST include this Fully Completed Application.
FRIVOLOUS FORMS WILL BE DISCARDED.

ATTENTION: Dealer Services Department

SUBJECT: Zippo Dealer Enrollment Application

Your Name

Company Name

Delivery Address

Invoice Address

City
 State   Zip+4 
Phone
            Fax 
Date Business Started
   DUNS Acct. # 
Owners or Principals
 
E-Mail Address

Web Site URL

# of Locations
      Type of Business       
Activity

Resale Certificate #
       Tax ID # 

Bank Name & Branch

Bank Account Rep

Bank Address

City
 State   Zip+4 
Account Number


Credit Reference 1

Credit Reference 2

Credit Reference 3

Credit Reference 4

- Use This Area if additional space or notes are required -

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U.S. Sales Only. Please visit the Zippo International Distributor page for information on availability in your country.