About The Watershed Group | The Watershed Group

Dealer Registration

"*" indicates required fields

Step 1 of 2

Name*

First Last

Position*

Store Name*

Email*

Username*

Password*

Enter Password Confirm Password

1. Company Information

Legal Company Name:*

D.B.A. Name:*

Your Watershed Group Account Manager:*

Ship To Address:*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please Complete The Appropriate Section Below

Business Type*

Coporation

Sole Proprietorship

Patnership

Date Incorporated:*

1. Name of Shareholder:*

Percent of Ownership:*

Telephone Number:*

Home Address:*

2. Name of Shareholder:

Percent of Ownership:

Telephone Number:

Home Address:

3. Name of Shareholder:

Percent of Ownership:

Telephone Number:

Home Address:

Date Established:

Name of Owner:

Telephone Number:

Home Address:

1. Name of Partner:*

Telephone Number:*

Home Address:*

2. Name of Partner:

Telephone Number:

Home Address:

Contact Information:

Buyer Name:*

Phone Number:*

Email Address:*

Accounts Payable Name:*

Phone Number:*

Email Address:*

Credit Card Usage Authorization Form:

Country*

Canada

United States

Persons Name on Card:*

Credit Card Type*

Credit Card Number*

Expiration Date*

CVV*

Billing Address*

Street Address City State / Province / Region ZIP / Postal Code

IMPORTANT NOTES All transactions moving forward will be billed with the information provided above. 2% surcharge will be added to all invoices when paid using a credit card. Any foreign currency, or prepaid credit card charges that are charged by the issuing credit card provider are the responsibility of the customer. The Watershed Group is not responsible for these charges and accordingly cannot reimburse for same. *If updated credit card information is not given as needed then processing delay's can be expected.

IMPORTANT NOTES All transactions moving forward will be billed with the information provided above. Any foreign currency, or prepaid credit card charges that are charged by the issuing credit card provider are the responsibility of the customer. The Watershed Group is not responsible for these charges and accordingly cannot reimburse for same. *If updated credit card information is not given as needed then processing delays can be expected.

Dealer Registration

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