Syndicate Sales, Inc.

ROLO Registration Request

All requests must be approved by the Participating Distributor(s).


Business Name:
Business Type:
Shipping Address:
City, State, Zip:
Mailing Address:	Same as Shipping
City, State, Zip:

Email Address:
Phone Number:
Contact Name:
Job Title:
Website Address:

Years in Business:
Do you currently use Syndicate Product?
Are you affiliated with any of the following? Check all That Apply	1-800 Flowers FTD Teleflora

You must choose a distributor within your general marketing area. Select Your Participating Distributor(s)
Selection	Distributor
1st
2nd
3rd