Adar Medical Uniforms

ADAR customer application form

Enter all your company information Company Information

Company name (As it apprears on your legal documentation)*

Country*

Billing address*

Address line 2

City*

State*

Zip code*

Website

Type of business*

Other

Federal tax ID/ EIN#*

Full name*

Email*

Phone number *

Resale certificate*

Resale certificate SELECT FILE

Store imagery (Optional)

Upload file SELECT FILE

Include information about your business (Optional)

ONLY QUALIFIED RESELLERS WILL BE GRANTED
B2B PORTAL ACCESS.

We tried making the prompts simple for you. Contact us with your
queries.

fill us in on all physical locations

The locations you enter now will be pre-approved for shipments later, so make
sure to click “+ Add location” button to add all current locations to your
account profile.

Physical store address

Same as billing address

Store name*

Country*

Address*

Address line 2 (Suite or Apt#)

City*

Province/ Region

Postal/ ZIP code

Phone number

+ ADD LOCATION

YOU’RE A STEP CLOSER TO BECOMING AN ADAR B2B RESELLER.

We tried making the prompts simple for you. Contact us with your
queries.

PAY ATTENTION NOW SO WE CAN CONTACT YOU LATER

Contact is key when it comes to receiving updates as anapproved Adar B2B reseller.

PO point of contact

First name*

Last name*

Title

Email*

Phone number

Direct phone line (For time sensitive contact)

AP POINT OF CONTACT

Accounts Payable (Click here if the information is the same as above)

First name*

Last name*

Title

Email (Statements will be emailed)*

Phone number

Direct phone line (For time sensitive contact)

SET YOUR B2B RESELLER PREFERENCES ON AUTOPILOT NOW.

Since our portal is automated, we want our communication to be
seamless. Contact us via email with your queries.

ENTER YOUR INFO TO BE REDIRECTED FOR APPLICATION REVIEW

This is the final step before we review your application.

First name*

Last name*

Password*

Confirm password*

Notes

PASSWORD REQUIREMENTS:

Must contain at least 8 characters
Must combine upper and lower case letters
Must contain at least 1 number

I agree to only sell at the location entered in this application.

I agree not to sell on any digital platform (including but not limited to third-party marketplaces, social media platforms, and company websites)

I agree to follow Adar’s Terms and Conditions and MAP Policy.

Please agree to all terms by clicking checkbox.

YOUR PASSWORD IS YOUR PASS TO OUR UPGRADED PORTAL.
WELCOME. CONTACT US VIA EMAIL WITH YOUR QUERIES.

Enter your info to be redirected for application review. This is the
final step before we review your application.

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