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 Wholesale Dealer Application 
To apply for a wholesale account, please fill out and submit the form below. Fields marked with an asterisk (*) are required.

Please be sure to provide us with a valid email address so that we can notify you once your account has been approved and activated.

We require that your first wholesale order be for a minimum of $1,000. There is no minimum order requirement on subsequent orders.

Personal Information
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Business Information
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Billing Address
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Shipping Address (if different)
 
Additional Information
How Did You Find Us?:
 
Will You Be Selling Our Products Online?:
 
Please Select the Category That Best Applies to Your Organization:
 
 
 
By clicking "SUBMIT" you are verifying that you have read and agreed to our "Terms & Conditions" and "Dealer Agreement."
 
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You may order from this site with confidence that your private information is secure.

Serving your water treatment needs since 1986

LivingWaters™ Engineered Water Treatment Solutions
P. O. Box 7261
Woodland Park, Colorado 80863
Phone: 719-687-2928

To email us, click here.

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