New Account & Catalog Request

Thank you for considering Nelsen Corporation as your supplier!
Nelsen Corporation is a wholesale distributor whose sales policy is to sell only to professional dealers who sell, install and/or service any material purchased from Nelsen Corporation. All potential customers must be qualified before receiving a catalog and establishing an account.

As a professional dealer, we hope you understand and respect our policy and the need to qualify each company requesting information from Nelsen Corporation.

Company Information

Company Name
Mailing Address

Please Send Catalog

Shipping Address:


Nelsen Corporation has the ability to email invoices to your Company rather than sending them via US Mail. Please provide the email address for your Accounts Payable Contact.

Buyer/Contact Name
Buyer/Contact Phone Number
Buyer/Contact Fax Number
Buyer/Contact E-mail Address
Accounts Payable/Contact Name
Accounts Payable Phone Number
Accounts Payable eMail

Purchasing Information

As a wholesale only distributor representing over
4,000 products from 200 vendors, we would like to
understand how we can best serve you. The answers
to the following questions will enable Nelsen Corporation to quickly expedite your application, qualify your account with our Company and understand the types of products that you use.

Estimated Qty
Water Softeners
Water Filters
Chemical Feed Pumps
Ultraviolet Systems
RO Systems
Engineered Systems
Water Well Pumps

For Office Use Only    

Please Fax this Completed Form to 330.745.1056
or email using the Submit button below.



1012 Assembly Circle, Suite 100 
Shertz, TX  78154
5120 E. Adamo Dr,
Suite F
Tampa, FL 33619
Phone: 800.362.9686
Fax: 888.544.8780
Phone: 866.445.4299
Fax: 602.442.0447
Phone: 855.674.0357
Fax: 210.714.2571
Phone: 866.712.6796
Fax: 813.712.2274