DEALER REGISTRATION INFORMATION

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* Completed and Submitted By:

* Position:

* Legal Business Name:

* Operating As:

* Address Line 1:

Address Line 2:

* Country:

* State / Province:

* City / Town:

* Zip Code / Postal Code:

Telephone Number:

Cell Number:

Fax Number:

* # years in business at current location:

* Main Contact for PUDO Inc. Program:

* Main Contact email address:

Referred by:

Business Hours:

Open 24 hours

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Other than English, what other languages are spoken:

Do you offer Fax services: Yes No

Do you offer Photo copying services: Yes No

I agree to terms and conditions:
I authorize PUDO Inc. to register our acceptance and participation in the Courier Shipment Handling Program.
(*Please complete all information above)

Submit