Wholesale Distribution

Premium Electronic Cigarette is in the process of expanding its operations in United Stated, South America and Europe. If you would like to learn more about Premium Electronic Cigarette distribution program, Business Card or website affiliate programs or receive a wholesale catalog, then simply fill out the form below and our representative will contact you in the next 1-3 business days.

Online Wholesale Registration

Personal Information

Company Name: *

Street Address:

City: *

Zip:

State *

Country: *

Business Information

Retail Business Name:

Retail Location(s):

Employeer ID:

Annual Order Volume:

Contact Information

Contact Name: *

Direct Phone: *

Email Address: *

Comments:

Forms by Fax

If you prefer, you can fill out and fax a registration form to us. Click on the image to download the form.

Registration by Fax Form

If you have already received our wholesale catalog and would like to submit a new order by fax, then click below to download "Order by Fax" form.

Order by Fax Form

Adobe Acrobat reader is required to open the forms. Click here to get the Adobe reader.