Distributor/Dealer Request Form

Do you want to sell the most awesome first aid kits on the planet? If so, fill out the below form and we will get back to you.

Point of Contact Name(Required)
If you fill this out, we will reject your application. No one uses faxes anymore.
Email account used to place orders(Required)
This is the email address that will be used as the login and also will receive notifications and status updates for orders. Most businesses use a generic company address like operations@ or orders@ or sales@ for this.
How do you plan to market/sell our products?(Required)
Please enter a number from 5000 to 100000000.
Max. file size: 200 MB.
Max. file size: 200 MB.
I understand that if accepted there will be a minimum initial order, and I must maintain a minimum annual sales volume.(Required)
Want to keep up-to-date with our latest news and announcements?