Prospective Member Profile

Thank you for requesting more Information about NBS. So that we can better assist you please complete the information below.

Required fields are outlined in red.

Business Name

Your Name

Address

City

State

Select State AL AK AR AZ CA CO CT DE FL GA ID IL IN IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY AB BC MB NB NL NT NS NU ON PE QC SK YT

Zip

Business Phone

Cell Phone

E-mail Address

Are you currently a Member of a Buying Group?

Yes No

(If yes, Please Name)

Please list your top 5 Vendors including Distributors

Please list your top 5 Categories

Retail Sales $ Volume

Number of Years in Business

Number of Retail Locations

How were you referred to NBS?

How would you prefer to be contacted?

Select Contact Method Business Phone Cell Phone Email

Type the above number:

SUBMIT