Wholesale Account Application

Thank you for your interest in becoming a wholesale customer of Holiday LiteSource, Inc. - please complete the form below to apply for a wholesale customer account. We ask for complete information so we can expedite the application and approval of your wholesale account. A copy of your company sales tax certificate or EIN certificate must be attached to this form or faxed to our toll-free fax # 888-762-2852 to process your application. Applications received without a copy of your company's certificate will be held until we receive all required information. Upon approval we will send a unique user name and password so you can view pricing and place orders on our website. If you have questions while completing this form, please contact us.
 Company Information
Business Name
Buyer Name
Mailing Address
Address
City
State, Zip
Phone
Alternate Phone
  
Fax
E-mail
Sales Tax ID or EIN
Please send us a copy of your sales tax or EIN certificate upon submitting this form.
Fax to 888-762-2852 or attach document below.
PDF or Microsoft Word document attachment only
 Shipping Information
  Shipping Address is the same as Company Address
Business Name
Contact Name / Department
Shipping Address
Shipping Address #2
City
State, Zip
Phone
Type of Shipment
Commercial
Residential
Local Pickup
Please indicate if your shipping address is a residential or commercial address so we can choose the quickest and most economical carrier for your location. If you want to pick up your order from our warehouse in Lubbock, TX please choose "Local Pickup".
 Order Preferences
Invoice Receipt
How do you want to receive your invoice?
Mail
E-Mail
Backorders
Do you generally prefer complete shipments or are partial/backorders okay?
Yes
No
 Payment Information
We require a written credit card for payment authorization on a first time orders. Although the payment form is not required to submit this application, it must be completed before your order can be processed and shipped.
If you are ready to place an order and want to accelerate the order process, please complete the LiteSource Payment Form and fax to our toll-free fax 888-762-2852.
About Your
Company
Briefly describe your company's operations so we can understand your business better.
How long have you been in business?
How many employees do you have?
Do you offer a web-based business? [Please list website address(s)]
Additional Comments
  Please keep me informed about upcoming specials,
        product news and company announcements at LiteSource.
  I would like to receive the LiteSource catalog by mail.
 Confirmation

Please remember to attach a copy of your company sales tax or EIN certificate to this form or fax it to our toll-free fax # 888-762-2852 to process your application. We require this information to qualify your company for wholesale purchasing and cannot complete your application process until we receive all required information. Thank you for completing this application form and we look forward to working with your company.

Attention Texas-based companies: Please complete the Texas Sales Tax Form attach to this application or fax back to our toll-free fax 888-762-2852.

Submitting this information does not guarantee wholesale account status and you accept the terms, conditions, and policies/procedures of Holiday LiteSource, Inc. Please read our complete terms, conditions and all policies/procedures.

Holiday LiteSource, Inc. does not share your private information with anyone for any reason. We only collect the minimal amount of information that we need to provide our services. Please read our complete Privacy Policy.

      Thank you for your interest in Holiday LiteSource!