Wholesale Application - Splash Supply Company

Wholesale Account Application

Name *

First

Last

Phone *

Email *

Business Name *

Business Address *

Address Line 1

Address Line 2

City

State

Zip Code

Is your shipping address the same as your business address? *

Business Website URL *

State Contractor Number or EIN *

How would you describe your business? *

Are you a Certified Aquascape Contractor (CAC)? *

Which of the following services are you interested in? (Check all that apply) *

Wholesale Water Feature Supplies
Wholesale Aquatic Plants
Water Feature Design, Engineering & Estimating Assistance
Website Design Services

Once we approve your application, you will have the option to order products from our online store (store.splashsupplyco.com) with contractor discounts. Products can also be purchased in-person at Splash or by phone/text/email. Please call ahead for large orders and custom-cut items like liner and underlayment.

Please choose a PASSWORD for your online store and/or plants account(s): *

Please re-enter the PASSWORD for your online store/plants account(s): *

Anything else?