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High Quality Rechargeable Batteries, Battery Chargers, Flashlights, And Mobile Energy Products

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Horizon Battery
1001 Lower Landing Rd Ste 101
Blackwood,NJ 08012
1-800-648-7239
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Quick Dealer Application

This application is reserved for customers that have been in business for more than one year. Please fill in the following questions that apply and submit.

Your information is sent via our secure server and is only used for the purpose of establishing a business relationship with The Horizon Group. You may also print the completed form and fax it to: 856-582-5399. Most applications are processed within 24 hours.

Dealer Information
Company *
Federal ID# *
Website
First Name *
Last Name *
Email *
Accounts Payable Contact Name *
Email For Accounts Payable *
Phone *
Fax
Street Address 1 *
Street Address 2
City *
State *
Postal Code *
Bank Name *
Bank Address *
Bank City State Zip *
Bank Account Number
Bank Phone Number *
Bank Primary Contact *
May we contact your bank if we need to? *
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Credit Card Account #
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Resale Certificate # *
Are all purchases exempt? *
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Your digital signature approves us to check you credit and extend you terms.

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