Plugfones ASI Member Application Please fill out the form to apply as an ASI/SAGE distributor If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required. ASI # * SAGE # Legal Business Name * Contact Name * Contact Phone * Contact Email * Address 1 * Address 2 City * State * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip / Post Code * EIN * Sales Tax Exemption Number * Description of business * Multiple Locations/Regions * YesNo Other Locations listed by City Location Sales Volume Annually * <100,000 100,000-500,000 500,000-1,000,000 >1,000,000 Any other information that would help us approve your application *
