Buyer Registration

Before proceeding, please open and read the: RoJico Buyer Agreement

Once you click the submit button and fax your resell permit and any other required identifications (see previous page) to 661-616-4019, you may immediately call us at 877-550-0600 and we can review and process your application and take your first order...or we will contact you within 48 hours to take your order.

Once approved for buying, your current email will serve as your login (you can change that if your email changes), and we will provide you a unique password that will enable you to access the Dealer Site for prices, ordering, helpful tools, order archiving, and more.

Note: In filing out the form, please do not use any quote or apostrophes anywhere in your application answers...for some reason, our system does not allow them. Your application will not be submitted properly if you use them.

First Name:	*
Last Name:	*
E-mail Address:	*
Business Phone Number:	Ext. *
FAX Number:
Cell / Other Phone Number:	Ext.
Street Address:	*
Suite (if required):
Your City:	*
State / Province:	*
Zip / Postal Code:	*
Company Name:	*
Retail Permit Number (if applicable):
State/ Province Permit Issued:
Company Website (http://):
Your Position / Title:	*
Company's Physical Location:	*
Business Category:	*
Please provide us a Brief Business Summary: (How long in business, specialties, product lines carried, etc.)	*
How did you hear about RoJico?	*

I have read and agree to the Dealer Application Agreement. I know that my buyer status may be terminated if I do not comply with the rules set forth in this agreement. (You will be sent your login/password or contacted upon submission of this application.) You MUST enter the code shown below in the box - exactly as shown or you will be required to start again from the beginning!

Having problems with this form? E-mail Us!

Top