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Business Owner *Must list all owners of the business

Business Email Address *

Business Contact Number *

Registered Business Address *

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Business URL *

Proof of Registration *

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Proof of Insurance *

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Business Structure *

Business Type *

Year Company Founded *

Number of Employees *

Vendor Type *

Nature of Business/Trade *Accessories/JewelryApparel (incl. socks, shoes, outerwear)Auto AccessoriesBags & AccessoriesBaked Goods / EdiblesDesk & OfficeDrinkwareHealth & BeautyHome Goods (incl. kitchen, bath, artwork)Paddles/Wooden CraftsServices (i.e. embroidery, printing, etc.)Sports & Outdoors (incl. swimwear, umbrellas)Technology/ElectronicsToys & NoveltiesOther

Company Description *

Distributors / Manufacturers *DropshippingPrint on Demand (i.e. Printful, Printify, etc.)Outsourcing (i.e. Alibaba, DHGate, etc.)Local Supplier (i.e. Jiffy, Ninja, etc.)Not Applicable

Marketing Platforms *FacebookInstagramLinkedInTikTokYouTubeNot Applicable

Business Representative *

Business Representative Email *

Membership Chapter *

Consent *

Yes, I agree with the privacy policy and terms and conditions. The terms and conditions need to be signed and emailed to vendor@communicationsatdpr.com.

Non-Refundable Application Fee ($25.00) *

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Contact

communications@deltapsirho.com
833.DPSIRHO (377-4746)

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