Health Organization and Non-Profit Application
All information is strictly confidential.
Fields marked with * are required.

If your organization already has an account with Global Protection Corp., please fill out the form to your right and your account will be set up in approximately one business day. Once set up, your username and password will be emailed to you.

If you are not yet a customer, we will require some additional identifying information in order to set up your account. This may be done with any two of the following:

  • Copy of your organization's letterhead
  • Non-profit certificate
  • Tax exemption certificate or ID
  • Letter from accounting or controller

After submitting the web form, please fax the documents to 617.946.3246. If we require additional information or have questions about your application, we will contact you. Once all information is received and verified, your account will be set up in about a business day. Your username and password will be emailed to you when the account is accessible.

Should you have any questions about the application process or the status of an application, please call 888.714.2200.
Organization Name*:
I would like to request billing terms for this account. This is optional. All web store accounts are set up to be able to purchase with a credit card. Note: This request may require additional information, such as business references, at the discretion of our accounting department.
Tax Identification Number*
Global Protection Account Number (Existing Customers):
Non-Profit Number (503C):
Name*
Address*
City*
State*
Zip*
Phone*
Fax
Email*
Contact
Address
City
State
Zip
Phone
Fax
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Contact
Address
City
State
Zip
Phone
Fax
Email