Become a customer

down

fill the form to

Become a customer.

Please fill out the application below to apply to buy our products directly.

After processing your registration, we will assign you a sales representative and give you the credentials to access our e-commerce

Please provide:
Color ID Copy of the owners and authorized contacts
After reviewing you application we will contact you to provide Certificate of Incorporation or Certificate of Formation.
We will send you the Customer agreement to be signed.
Please note:
If you only want to buy e-commerce, click HERE to go directly to our online store where you will find a simplified version of the registration form and you can make purchases immediately via PayPal

    • 1

      Section 1

    • 2

      Section 2

    • 3

      Section 3

    1/3

    Section 1

    Business information

    Is this company a subsidiary of another company?

    Business / Billing Address:

    Offices:
    Company is:

    Business / Billing Address:

    Billing Address same as Shipping address?

    The Client commits to notify Cubix, in writing, any change of ownership of his company within ten (10) working days of occurrence.

    Owner information

    Please list all owners with 25% or greater ownership in business, in order by greatest to least

    Principal 1

    Have you ever filed for bankruptcy?
    Add Principal 1?

    Principal 2

    Have you ever filed for bankruptcy?
    Add Principal 3?

    Principal 3

    Have you ever filed for bankruptcy?

    Authorized contact persons information

    Purchase Order Authorization
    Note: Only the person(s) listed here are authorized to place Purchase Orders