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REGISTER

Please fill this form in and click send to register.

The Certificate Source is a wholesaler -- we can only sell to retail businesses that resell our products. Before we can quote prices, send samples, etc., we need to verify that you qualify for this business relationship. You will need to provide your ASI, ARA or PPAI number. If you do not belong to one of these associations we need your retail sales license number and statement that your items are for resale, and not personal use. If you are unable to meet the above requirements, let us know and we will refer you to a dealer in your area that should be able to meet your needs.

first name


last name


email


company


phone


fax


address


city


state
zip code



password


confirm password

RETAIL VERIFICATION
Please enter one of the following:

PPAI #


ASI #


ARA #


Retail Tax ID #