Vendor Connect Membership Form – PayPal Tx

Thank you!

Your Vendor Connect membership payment has been completed, and a receipt for your purchase has been emailed to you by PayPal.

You may log into your PayPal account at www.paypal.com/us to view details of this transaction.

Please provide us with the following information below:

If you prefer, you may download our Vendor Connect Membership Form (PDF) instead and fax/email back to us by clicking here.

When entering your business’/company’s Service Categories below, please refer to 6Beds Vendor Connect Service Categories (PDF) and list all that applies to your business/company.

[contact-form to=’advocate@6beds.org, subscriptions@6beds.org’ subject=’New Vendor Connect Membership’][contact-field label=’Business Name’ type=’name’ required=’1’/][contact-field label=’Email’ type=’email’ required=’1’/][contact-field label=’Website’ type=’url’/][contact-field label=’Phone No.’ type=’text’ required=’1’/][contact-field label=’Fax No.’ type=’text’/][contact-field label=’Business Address, City Sate, Zip’ type=’textarea’/][contact-field label=’Contact Name’ type=’text’ required=’1’/][contact-field label=’Contact Email’ type=’email’ required=’1’/][contact-field label=’Contact Phone No.’ type=’text’/][contact-field label=’Service Categories’ type=’textarea’/][contact-field label=’Comment’ type=’textarea’/][/contact-form]