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User Account Request for WiseBuys

All information is required to process your application

Enter your customer number: (your WiseBuys salesperson or customer company point of contact will know this)

Your company name:

Enter the department: (Departments are customer chosen and should already be setup - if you don't know your department, call Support at 800-642-6120 and ask the agent to help you find your department name)

Note: If you require supply delivery to a specific address, you need a department in WiseBuys, otherwise, enter NA

(if you will order for multiple departments, please provide these in the comment box at the bottom of the form below)

(Departments can be names or numbers, depending on what your company has already set up with WiseBuys)

Please provide a brief explaination of the department:

(example: this is the purchasing department, or marketing department)

Your first name:

Your last name:

Company street address:


State Zipcode:

Phone number/Extension: (area code included)

Fax number:

Your email address:

Re-enter email address to verify:

Would you like to receive a confirmation email on all orders?

Will you require a Purchase Order on all orders?

Will this WiseBuys account require authorization from a supervisor?

If yes, enter the name of that supervisor here

Will you be using a credit card to pay for any WiseBuys purchase's?

Please enter your service center: (this is either where your representative is from or the location closest to you):

Use this box to provide any additional information or questions:

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