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Contact Us

We are currently signing up Suppliers and Buyers at this time.

Please fill out the below form below to be notified when we are ready to sign up Wholesalers.

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How did you hear about Diverse Powered Brands?(Required)

Wholesaler/Distributor Name:

Supplier Name:

Please share:

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Buyer Login Request

Name(Required)

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Job Title(Required)

What is Your Position Type?(Required)

Please select from the following:(Required)

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LinkedIN Profile URL(Required)

For validation purposes, please share with us your LinkedIN profile URL. If you do not have a LinkedIN, please share another digital source of confirmation (ie: you bio on company website).

How did you hear about us/Referred by:(Required)

Company Information

Company(Required)

Number of Buyers(Required)

Store Count(Required)

Coverage Area(Required)

i.e.:U.S. national buyer, U.S. specific region, Canada, France, etc.

If U.S., in what state are you located?

If U.S., what distributors do you use?

Supplier Diversity Program Information (as applicable)

Do you currently have a Supplier Diversity Program that includes diverse-owned businesses?(Required)

Yes

No

If Yes, please include your Supplier Diversity Manager/Director’s name, title, email, phone:

If yes, please include your Supplier Diversity Initiative Website URL :

If Yes, do you: Require third-party certification?

Yes

No

If No, do you have a plan to implement?

Yes

No

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Why are you interested in the Diverse Powered Brands and how will it assist your business goals?(Required)

Permission to use statement above as a testimonial on website, press release, media?(Required)

Yes

No

If Yes, permission to use:

First Name, Last Name, Title, Company

First Name, Title, Company

First Name, Company

Title, Company

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Supplier Register

Brands

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Email(Required)

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How Did You Hear About Us?(Required)

Administrator

Your Diverse Powered Brands account Administrator will be given admin access to the marketplace and will be responsible for creating and managing your company and brand pages.

Admin Name(Required)

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Admin Email(Required)

Credit Card

Card Details

Cardholder Name

Promo Code

Total

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