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PRODUCT CATEGORIES:
+ Bath Accessories
+ Locksets
+ Moen
+ Shower Enclosures
+ Heavy Glass
+ Melamine Organizers

New Customer Application

Please fill out the following form or click here for printer friendly (PDF) application.

Name:
Email:
Company Name:
Billing Address:
City:
State:
Zip:
Shipping Address:
(If Different from Billing)
City:
State:
Zip:
Type of Business:
As manufacturers of various bathroom accessories, Extreme Enclosures works closely with Wholesalers, Distributors, Contractors and Retail Establishments. Please help us to understand the complete nature of your business.
Method of Payment:
Please check the method of payment you will be using for future purchases. All information is kept completely confidential.
Visa   MasterCard   Discover
Personal Check
Name on Card:
Card Number:
Code #: (Back of Card)
Exp Date:
Expected Sales Volume:
Extreme Enclosures offers various price multipliers for volume purchases which are calculated quarterly. Please see our price multiplier chart and determine an amount that your company would expect to purchase each quarter so that we may establish a price multiplier for your company.
Expected Quarterly Sales Volume:$

Extreme Enclosures - 650 Stackstown Road, Marietta, PA 17547
Phone: (717) 426-4421 - Toll Free: 1(866) 363-5678 - Fax: (717) 426-4123 - Email: extremeenclosures@embarqmail.com