Become a Retailer

We invite to you inquire about becoming a retailer of IntelliGender®.   Our management team will respond to your request quickly via the email address you provided.  Please share more about your company and locations so we have an understanding of the proximity to our current retailers and opportunities.

    * required
    Company Name*:
    Contact Name*:
    Company Address*:
    City / St / Zip*:
    Shipping Address: (if different)
    City / St / Zip:
    Phone #*: (primary)
    Phone #: (alternative)
    # of Stores*:
    Location of Stores*:
    Email Address*:
    Website Address*:
    Initial Requested Order*:
    (min. of 1 case required - 24 in a case)

    Questions / Comments :