Thank you for your recent inquiry into becoming Dynarex Distributor Partner. Please complete the following credit application for our Finance Department.
Along with your completed credit application, please email/fax your Resale Certificate and 3 Credit References at
(firstname.lastname@example.org / 845-365-8229 Attn: Heidi)
If you are an International Distributor, please fill and sign our Non-Disclosure Agreement.
If you are a Canadian Distributor, please fill and sign our Canadian Distributor Agreement.
If you are requesting a credit line over $5,000, please include financial statement as well. Purchases must exceed $5,000 annually to qualify as an authorized distributor.
Your interest in Dynarex is appreciated and we look forward to serving you.
DISTRIBUTOR CREDIT APPLICATION (Must be completed in full)