WaterPlex Application Form
Please fill out the form below and click send. We will send you our dealer introductory package containing all the details.
So go ahead and open your own WaterPlex store today!
Be sure to visit our WaterPlex site at www.WaterPlex.com

 

Please fill out the following questions
to help our staff better assist you.

First Name*:   
Middle Initial:   
Last Name*:   
Address Line 1:   
Address Line 2:   
City:   
State:   
Zip*:   
 
Phone* (no dashes, ie:6125551212):  
Fax:   
Company Name:   
E-Mail*:   
* Indicates Required Field
 
I have retail experience
I would like to start right away
I plan on opening a store in more than a year
I presently work in the water filtration industry 
Please send additional information immediately 

Additional comments: