Since 1988, Metabolic Nutrition has sought to provide the highest quality nutraceuticals and extraordinary customer service. This goal is shared by all Metabolic Nutrition authorized resellers in our selective distribution program. To apply to become an authorized reseller please submit the completed application below, and fax certified business license to 305-945-0804.

 


Legal Business Name
 
Primary Contact Name
Billing Address
 
Primary Contact Phone
City
 
Primary Contact Fax  
State/Province
 
Primary Contact Address
Country
 
City 
Zip
 
State/Province
Company Telephone 
 
Zip 
Company Fax
 
Primary Contact E-mail Address 
Company Website(s)
 
Purchasing Agent
Principal  
 
Type of Company
(please select one) 		Corporation
Partnership 		Sole Proprietorship
Other
   If other, please indicate
 
Chief Financial Officer
Marketing Manager
 
Federal Tax ID #
       

 

Please indicate all geographic areas served (describe with as much detail as necessary, cites, province, Canadian regions, international regions, etc.):
Do you intend to export any Metabolic Nutrition products? Yes No
If yes, please specify:
 
 

Number of facilities/offices Total number of employees Approximate annual revenue
$
Does your company sell any product via the Internet? Yes No
If yes, what percentage of sales come from the Internet?
Does your company sell products via mail order? Yes No
If yes, what percentage of sales come from mail order?
How many years in business? Indicate any extenuating circumstances (new ownership, etc.)
Which products are you interested in representing?

Advantage
Ametrol
CGP
Hydravax
Zymatein 		Liposin
Oxlin
Pervalid
Phenolox 		Protizyme
Quidprim
Raeval
Stipatore 		SyneDrex
TAG
Tenefem
Thyrene 		Ideal Body Solutions
Sports Performance
Health & Wellness
All of the Above

What other manufacturers' products do you carry?
Other than nutraceuticals, what products do you sell?  
Describe store location (stand-alone, boutique, strip mall, etc.):
Describe store appearance and please provide photos of store front, merchandise layout, register, and service areas:
   
Attach Files Here:
Files Attached:

Please attach any additional information related to your business, i.e., recent marketing initiatives, etc.
 
Attach Files Here:
Files Attached: