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Company Information

Business Profile

Trades *
Team Size
Annual Revenue ($)

Distributors & Account Numbers

Main
Secondary
Tertiary
Distributor #4
Distributor #5
+ Add Row

Customer Financing (Optional)

Who is your Finance Provider?
Approx. Monthly Financed Amount ($)

Notes (Optional)

Agreement & Signature

By signing below, you request participation in Tiny GPO to access vendor rebates and related benefits. Rebates are determined and paid by manufacturers/distributors. Tiny consolidates reporting and passes through rebates after receipt.

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