I confirm that the information provided in this application is true and correct. I understand that submitting this form does not automatically guarantee acceptance as an Eco Pure Products reseller. If approved, I agree to represent the products honestly and professionally, use approved product information and branding, and comply with the reseller pricing, payment and ordering terms provided to me.

I consent to Eco Pure Products collecting and using the information supplied in this form for the purpose of reviewing my reseller application, communicating with me and managing the reseller relationship. I understand that my personal information will be handled responsibly and will not be shared unnecessarily.