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Accessability Controls
800-522-6294 / TTY 800-281-3555
MaxiAids.com - Accessible website for online shopping offering independent living products for blindness, low vision, deaf, hard of hearing, seniors
MaxiAids.com - Products for independent living
FREE domestic shipping on web orders of $74.95 or more (details)
See What's NEW! Shop CLEARANCE!
Create New Account
Thank you for your interest in becoming a dealer / wholesaler. In order to become a dealer / wholesaler, please create an account by completing the form below and submitting it to us. Additionally, you must provide us with the following information (fax 631-752-0689):
- Copy of resale certificate or federal tax id
- one banking and three business references
Your account will only become dealer active once we receive required information from you and approve your new account.
Account Information
Email Address (this will be your sign in id)

Sign up for email updates
Password (case sensitive & no special characters)

Billing Information (Use address that appears on your credit card or bank statement)
First Name
    Last Name

Company Name
    Phone Number

Address
Check if this Address is a P.O. Box

City
  State
  Zip/PostCode

Country
My billing address is my shipping address
By submiting this form, you read and agreed to our Terms & Conditions

We do not sell or disclose any personal information about our users. Transactions for orders placed on this site are conducted via 100% secure connection. To learn more how we safeguard your personal information, please review our Privacy & Security Statement

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