Wholesale & Distributor Form
Each application is assessed individually. The approval process can take 5-7 business days. Once approved, an account invite will be emailed to the e-mail on file. For any questions or concerns regarding the status of your application please email us at: info@nooranitradinginc.com. We look forward to doing business with you.
Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
 -
Area Code
Phone Number
Company Name:
*
Company DBA:
Number of years in business:
*
Shipping Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
*If your location is outside of the United States, please provide that address here. Billing Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Tax ID:
*
Type of Business:
*
Wholesale & Distribution
Cash & Carry
Retail Storefront
E-Commerce/Online Storefront
Gas Station/Convenience & Grocery
Amazon/eBay
Shipping Location Type:
*
Warehouse with loading dock
Store
Residence
Storage WITHOUT a loading dock
Storage WITH a loading dock
Freight Forwarding Company
Hold shipment at closest dock
Please list all of the cities you will be selling in:
*
Do you have a forklift on site?
*
YES or NO
Shipping Requests:
Please let us know any extra shipping instructions.
How did you hear about Blunteffects® Air-fresheners?
*
Please submit your proof of business. (ex. Tax ID, Business License, Articles of Incorporation)
*
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