Wave Werx

become a distributor

Distributor form application

DISTRIBUTOR INFORMATION SHEET 2025

1. Company Information

will be used in all documents issued

2. Contact Information

3. Business Activity

Percent of business (totals must equal 100%)


Business Details
This only applies if you selected "Distributor" in the field above.

4. Marketing & Advertising

How did you learn about Wavewerx?

5. Import & Shipping

Currently doing business with China/Taiwan

6. Additional Information

* Required fields.

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