Become a Dealer

If you are a retailer that has consumers in the agriculture, construction, automotive, oil & gas, forestry or trucking industries then you are what we are looking for.

Please complete the following information. Upon receipt you will be contacted by one of Milligan Bio-Tech's sales representatives.

Company Name: *
Contact First Name: *
Contact Last Name: *
Mailing Address: *
Shipping Address:*
City/Town: *
Province/State: *
Postal/Zip Code: *
Country: *
Phone #: *
Fax #:
E-mail Address: *
Website:
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