Fill out the form below to start your application with Amazon Hub Delivery.
Please note: This form is for registered businesses only.

First Name *

Last Name *

Email Address * Please use an email address that you will have access to for the duration of your application

Phone Number *

Legal Business Name * Legal Business Name or DBA

Business Street Address *

City * City where your business is located

State * AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY State where your business is located

Zip Code * Zip code where your business is located

How did you hear about us? * Amazon Representative Visit Referral Chamber of Commerce or Local Oganization Local Event Google Facebook Postcard Newspaper Ad Radio Ad Email Instagram LinkedIn Mobile Ad Nextdoor App Door hanger Outdoor Billboard iHeart Streaming/Broadcast TV Reddit Select an answer choice from the list

Referral First Name The first name of the person who referred you.

Referral Last Name The last name of the person who referred you.

Referral Email The email address of the person / Chamber who referred you.

Sales Assistant * The name of the Amazon Representative that helped you.

Comments

By submitting this form I hereby acknowledge that the information collected on this intake form is true, accurate, and will be used in the application process to become an Amazon Hub Partner. If the information I provide is not true and accurate, I understand that Amazon may no longer consider my company for Hub Delivery.