ProHealth

Wholesale Application Form

Dear Valued Customer

Thank you for your interest in registering a wholesale account with us at ProHealth Inc.

In order to open a wholesale account we would like to verify that you are an active
business. Please complete and submit the following via email to wholesale@prohealth.com
once we verify your business information we will contact you to provide product info,
pricing, terms & conditions.

Company Name:
Company Address:
City, State:
Zip code:
Phone Number:
Fax Number:
Contact Person
Email Address:
Federal Tax ID#:
CA Re-sale permit #
www.cdtfa.ca.gov
Website address:
Type of business:
Year established:

**Note:
 Only selected ProHealth and ProHealth Longevity products are available
at wholesale pricing
 A minimum of 12units per SKU are available at wholesale prices
 Orders $1000.00 USD and over receive free U.S. Domestic USPS shipping
(excluding Alaska, Hawaii, & Puerto Rico)
 Fed Tax ID# and CA Resale permit # required

Please note we will contact you if we have further questions. Also note the verification
process may take up to 48hrs.

Please do not hesitate to contact us at wholesale@prohealth.com or call 800-366-6056 if

you have any questions regarding this application.

ProHealth Inc
555 Maple Ave. Carpenteria, CA 93013