Independent Delivery Service Provider Request Form

The Independent Delivery Service Providers are a key partner to the consumers who want the best & most convenient services. The first step in the process is to let us know you are interested! Complete the form and click "Submit". Among other criteria, partners are selected based on demand, geographic location, and commitment to customer service!

Your First Name:
Your Last Name:
Your Email:
Phone:
Choose your Username:
If different, enter the business manager or owner's information.
Owner's/Manager's First Name:
Owner's/Manager's Last Name:
Owner's/Manager's Email:
Enter the following information as you want it to be displayed on the website
Store Name:
Store Address:
Store City:
Store State:
Store Postal:
Store Country:
What kind of business are you?

Do you have a customer list that use Mosquito Magnets?	Yes
Do you currently sell Mosquito Magnet products?	Yes
If yes, who do you current purchase from?
Are you currently selling propane to consumers?	Yes
Do you carry the proper license and permits to deliver propance in your area?	Yes
Do you have a store with a sign up front?	Yes

By requesting to become an Independent Delivery Service Provider, there is no obligation on your or Woodstream Corporation's behalf to become partners or advertise your business. After submitting the request, information will be communicated about the next steps in becoming part of the 360° Customer Support Network! All requests are pending approval.