Wholesale Form

1
Company Name* This field is required.Type your Company Name Here:
2
Company Shipping Address* This field is required.If your Billing Address differs from your shipping address listed here, please email sales@ancap-usa.com
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
3
Your Name* This field is required.Type Your Name Here
First Name
Last Name
4
Your Position or Title at the Company Applying for Wholesale* This field is required.Ex. Owner, Manager, Wholesale Account Manager, Buyer, etc.
5
Primary Email* This field is required.Please enter the email that primary business correspondence should be sent to, this will include PO confirmations, receipts, shipping notifications, etc.
example@example.com
6
Company Phone Number* This field is required.Include your company direct line or ext. if applicable.
Area Code
Phone Number
7
Number of Years of Company Operation* This field is required.How long has your company been in business?
8
URL Link to Your Company Website or InstagramIf you have a website, providing it can help the application process.
9
Choose All that Apply to Your Business* This field is required.What type of products/services do you provide?
Bakery
Cafe
Coffee Roaster
Multi-Site Cafe
Restaurant
Retailer
Wholesale Roaster
Consulting Firm
Design Firm
Non-Restaurant Industry Business
10
How did you hear about Ancap USA?* This field is required.Any information you can provide is greatly appreciated.
I'm a returning customer.
Referral
Google
Another Search Egine
I saw Ancap in a cafe.
I saw Ancap listed on Retail websites.
I saw Ancap for sale at a brick & mortar store.
I am familiar with Ancap S.p.A. in Italy.
Social Media
Trade Show
Print Ad
11
Check All that Apply.* This field is required.I would like to receive more information regarding the following.
I am interested in ordering wholesale for my business.
I am interested in Ancap Custom.
I will be reselling Ancap pieces.
I would like to talk about business integration options with Ancap USA.
I would like to receive samples.
Sign me up for the wholesale newsletter.
12
Check All that Apply.Let us know what you are interested in.
Verona Line
Torino Line
Dinnerware
Verona Painted Rim Cups & Saucers
Verona Striped Cups & Saucers
Verona Open Handle Line
13
Tax ID Number* This field is required.In order to set up a wholesale account, Ancap will need your Company Tax ID number. If you are starting a company and do not yet have a Tax Id Number, please enter "New Company," and our Sales Team will reach out to you.
14
Resale Certificate ID Number* This field is required.In order to exempt your purchases from taxation, a valid Resale Certificate must be on file with Ancap USA. Please type the ID Number Here:
15
Upload a Copy of Your State Resale CertificateIn order to exempt your purchases from taxation, a valid Resale Certificate must be on file with Ancap USA. Please Upload a Copy Here:
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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16
Upload Vector Files for Ancap CustomTo receive a Custom Quote, please email custom@ancap-usa.com. You will be asked to provide a vector image file. You can submit that now if you would like.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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