Request Account

Institutional Accounts

Any Federal, State, City or County Government.  Military, Hospitals, Schools (Public/Private) including Colleges, Housing Authority or Prisons.


Resale Accounts

Apartments, Condominiums, Churches, Contractors/Home Improvement Companies,  Building Supply Companies, Hardware Stores, Manufacturers, Glass/Screen Companies, Hotel/Motels, Property Mgmt/Real Estate.

Please click the form button below that best fits your business structure.  If you can’t determine which type fits your business, please don’t hesitate to call 800-638-2200 for assistance.

Print the form, fill it out including the signature, and either scan and email the form to Products@BlaineDistribution.com OR fax the form to 301-791-6982.

The form MUST have a signature.