Catalog Request Form

BC Distributing Catalog Request Form

Please fill in ALL fields to ensure proper processing.

(Scroll down to send form with "Submit" key.)

Name:
Business Name:
Address:
Address2:
Address3:
City:
State:
Zip Code:
Country:
Telephone #:
Fax #:
Email:
Tax ID# / Business Lisc #:
Business Type:
Your Website Address (optional):

BC Distributing must receive hard copies of Tax ID # / Business Liscence
before wholesale catalog and website login password is sent. After you have transmitted this form,
please mail or fax a copy of your reseller's information to us at:

BC Distributing

10554 Progress Way #L

Cypress, CA 90630

(714) 995-3997

(714) 995-4952 Fax