For Wholesale Distributors of iGlow Hair Gel - Creates Its Own Light, Without Black Lights

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Become an iGlow Distributor

If you'd like to set up a wholesale account, please fill out this form and supply us
with a hard copy of your resale permit or tax id via fax or mail.

You will receive information on placing orders, as well as your wholesale prices,
once your application has been accepted.

In order to set up your wholesale account, we will need a faxed (or emailed) copy of
your resale permit or tax id. Please fax us at (866) 568-3616, and include a page
with your telephone number and the name of the contact person or buyer. Thank
you!

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Password:

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iGlow(TM) Gels
Creates Its Own Light, Without Black lights

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Firm Name:

Permit Number:

Street Address:

Street Address 2:

City:

State:

Country:

Zip/Post Code:

[Contact Information]

First Name:

Last Name:

Title:

E-Mail Address:

Telephone Number:

(You may put in up to 3 phone numbers)

Fax Number:

Password Confirmation:

By clicking the submit button I hereby certify that I hold a valid seller's
permission issued to Sales and Use tax Law the tangible personal property
which I shall purchase from MG Technologies, LLC will be resold by me in the
form of tangible personal property; provided, however that in the event any of
such property is used for any purpose other than retention, demonstration or
display while holding it for sale in the regular course of business it is understood
that I am required by the Sales and Use Tax Law to report and pay for the tax,
measured by the purchase price of such property.

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