BasementDepot Knowledgebase Gallery of Basement Design & Ideas Basement Talk About our products Visit our Store Search for Products Get Extended Warranty and/or Buyer Protection Sell your products FEATURED PRODUCT Hydro-Seal 75 one gallon kit gray Hydro-Seal 75 water-base epoxy is an odorless, easy to apply waterproofing material developed with t... SUBSCRIBE TO OUR NEWSLETTER e-mail address name (optional) subscribe / unsubscribe If you are interested in becoming a Basement Depot Provider and selling your products through The Basement Depot, please complete the application below. Be sure to read the Terms and Conditions as they define your legal obligations and fees associated with your account, if approved. CONTACT INFORMATION Your First Name Your Last Name Company Name DBA (if applicable) Street Address Address (cont.) City State/Province Zip/Postal Code Country Phone Fax E-mail E-mail (confirm) COMPANY INFORMATION Number of Employees Date Business Started Type of Company Corporation Partnership Sole Proprietorship Other PRODUCT INFORMATION Describe the product line(s) you are interested in selling This description will appear next to your listing. Maximum length = 255 characters Do you carry liability insurance on the products you sell? YES   NO CREDIT CARD INFORMATION Name on Credit Card: Type of Credit Card: MasterCard Visa American Express Discover Credit Card Number: Card Verification Number: Expiration Date: 01 02 03 04 05 06 07 08 09 10 11 12 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Billing address (where you receive your credit card bills), if different from above Street: City: State: AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY AA AE AP AS PR FM GU MH MP PW VI Zip or Postal Code: AGREEMENTS I have read and agree to abide by the following: BasementDepot User Agreement (enter YES) BasementDepot Provider Agreement (enter YES) BasementDepot Store Guidelines (enter YES) BasementDepot Provider Fees (enter YES) This document will not be "signed" in the sense of a traditional paper document. To verify the contents of this form, the signatory must enter any combination of alpha/numeric characters that has been specifically adopted to serve the function of their legal signature. Pursuant to the Federal Electronic Signatures in Global and National Commerce Act and applicable state laws, I consent to The Basement Depot's use and reliance on my electronic signature to verify the information that I have provided herein. Today's Date: 07/05/2008 Your Signature: Your IP Address Is: 38.103.63.16 © Copyright 2005 Basement Depot.   All Rights Reserved. | HOME | CONTACT US | User Agreement | Privacy Statement | Contractor Control Panel | Basement Finishing | Basement Remodeling | Basement Waterproofing | Concrete Repair | Finished Basements Foundation Repair | Mold Removal | Sump-Pumps Related Links Total Unique Visitors: 92006 Since April 1, 2005 Problems with this website? webmaster@baystateservices.com Bay State Internet Services Unique Visitors today: 1837 Sat, 5 July 2008