MINDFUL MOSAIC WHOLESALE APPLICATION
Please fill in the form below to apply. A representative will contact you within 24 hours.
Full Name
*
Prefix
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
E-mail
*
What is the name of your company?
*
What is your company's website?
*
What is the address of the company?
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Where are you interested in selling Mindful Health's Mindful Mosaic® Collection?
*
E-commerce business where customers use your website to make a purchase
Physical store where customers come to your location
If you have a Physical Store, how many physical locations do you have?
If your primary business focus is as Physical Store, please describe your business in detail.
Please tell us a little more about your business and your current mission.
*
Please upload your business permit/license.
*
Browse Files
Cancel
of
How did you discover Mindful Health?
*
How did you hear about our wholesale program?
*
Authorized Resellers shall not sell or distribute Mindful Mosaic products (a) to other wholesalers, distributors, or other resellers; (b) through third-party websites (e.g. Amazon); or (c) by using drop-shipping or other similar selling practices. Further, Authorized Resellers are prohibited from, either directly or indirectly through third parties, selling or distributing Mindful Mosaic products through auction services (e.g. eBay), multi-level marketing, pyramid selling, network marketing, referral marketing, or similar selling practices.
*
I Accept
I Do Not Accept
A Mindful Health representative will contact you within 24 hrs.
Save
SUBMIT FORM
Should be Empty: