Buyers Club | Registration

The Buyers Club (BC) is a resource for programs that align with the principles of harm reduction. It leverages collective purchasing power to ensure the lowest-cost and highest quality harm reduction supplies are made available to all programs no matter their size.

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NASEN strives to provide affordable, high-quality harm reduction supplies to all of the incredible programs who are invested in continuing to nurture community and create positive change in the lives of the individuals we collectively serve and support.

Becoming a part of the NASEN Buyers Club community is entirely cost-free. We do ask that you kindly complete the application form below to unlock the full range of purchasing benefits. Please ensure that each agency submits only one application, utilizing a physical address (not a P.O. Box) for shipping and providing up-to-date contact details. Upon successful application approval, you will receive a welcome email with further instructions and information.

1. Program

Agency Name*

Program Name (if differs from Agency Name)

2. Your contact information

Please provide the contact information for the login credentials to be emailed to.

First Name*

Last Name*

Email*

Phone

3. Billing Contact

Add first billing contact using the form below. Additional billing contacts may be added after setting up your account. All billing contacts are subject to approval.

Reference Label (optional)

First Name*

Last Name*

Email*

Phone*

Address*

Suite, Unit, Apt #

City*

State* AKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPAPRRISCSDTNTXUTVAVTWAWIWVWY

Zip Code*

4. Shipping Address & Contact

Provide the primary shipping address you plan to ship to you for your agency below. Addresses must be complete and have a contact person assigned to them for shipping to occur. PO Box addresses are not allowed. Click here if the shipping address is the same as the billing address.

Reference Label (optional)

First Name*

Last Name*

Phone*

Address*

Suite, Unit, Apt #

City*

State* AKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPAPRRISCSDTNTXUTVAVTWAWIWVWY

Zip Code*

5. Tell us about your Syringe Service Program!

Are you a Syringe Service Program (SSP) / Syringe Exchange Program (SEP)?

Yes

No

Other:

What is your plan for sharps disposal?

Do you charge fees to your participants?

Yes

No

Other:

Do you have requirements for your participants to meet before receiving services and/or supplies?

Yes

No

Other:

If you're not an SSP/SEP:

This is for personal use.

Our organization is solely a naloxone distribution program.

We are in the process of starting an SSP/SEP.

Other:

What services do you provide?

May we contact you for research purposes?

Yes

No

Submit

I CERTIFY* that the facts contained in this application are true and complete to the best of my knowledge and understand that, if accepted into the Buyer's Club, false, misleading or incomplete statements on this application shall be grounds for dismissal.

Submit Application