Become an ECLIPSE™ Water Machine Distributor

Join our team of direct sales distributors and start selling the most widely recognized water filtration system in the direct sales industry!

Get started today by completing the Distributor Application below.

If you prefer, a printable application (pdf) is available for download.

QUESTIONS: Feel free to give us a call (toll-free) 1.888.386.0880 (M-F, 8 AM - 5 PM, PST).

Want to know more about becoming an ECLIPSE Water Machine Distributor, or how water filter sales can compliment your existing direct sales product line? Fill out our Information Request Form to learn more about all the benefits of this direct sales business opportunity.

Eclipse Distributor Application


	Contact Information
*Contact Name
Contact Title
Legal Business Name
Federal EIN or SSN
*Phone		Fax
*Primary Email
*Email
Website

	Billing Address
*Address
*City
State		Zip

	Shipping Address
Address
City
State		Zip

	Business Information
Business Type
Date Established	dd-mm-yyyy
Business License
Number of Employees
Number of Locations
List Products Currently Distributed
Primary Means of Distribution or Sales

	Business Credit References Please list three business credit references (suppliers):
	Credit Reference #1
*Business Name
*Address
*City
State		Zip
*Phone		Fax

	Credit Reference #2
*Business Name
*Address
*City
State		Zip
*Phone		Fax

	Credit Reference #3
*Business Name
*Address
*City
State		Zip
*Phone		Fax

PROMO CODE	If you have a promo code, enter it here.
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