Register Wholesale Account

In order to apply for a wholesale account, you must have a valid state tax id number, which is required on this form. We also require you to email an image of your business license to sales@demandvape.com.

If you already have an account with us, please login at the login page.

Your Personal Details

Customer Group

First Name

Last Name

E-Mail

Telephone

Fax

Your Company Address

Company

Address 1

Address 2

City

State / Region

Zip Code

Country

What are you interested in?

How did you hear about us?

Notes / Comments

Your Password

Password

Password Confirm

Newsletter

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