Pro Program

APPLICATION

Create an account first, then complete the form below.

Back in the day, everyone "had a guy" for everything ... give us a chance to be your lighting people today.

Pro Program Application

All submissions are subject to approval. Once approved, we'll email you a link to activate your lightingandbulbsunlimited.com account. Please fill out the form in completion, including city/state/zip.

T A X - E X E M P T

For Non-Tax statuses, please download and fill out this form . Orders will be taxable until this form has been submitted and approved.

C R E D I T

For NET30 accounts, please download and fill out this application. Credit line accounts are subject to approval and require credit references.

D I S C O U N T S

We offer you the ability to keep your discount exclusive to yourself, or allow for your own clients to place orders with your discount code. Please distinguish how you'd like your account set up when prompted below.

Name Email Phone Number

Company Name

Full Company Address

Street, City, Zip, & State

Website

Federal Tax ID

Social Media Handle

Tax Status*

*If tax exempt, please email a filled out the E-595E form to hello@lightingandbulbs.com after submitting this application form. Please note that orders will be taxable until confirmation of approval on tax-exempt status has been sent.

Trade Industry

What field/industry are you apart of?

Your Discount

Would your discount to be exclusive to you for your purchases, or do you want it to be extended to your customers (for clients who pay direct).

How did you hear about us?

Message