Wholesale Questionnaire Form

1
Name* This field is required.
First Name
Last Name
2
Please enter your company name below* This field is required.
3
Email
example@example.com
4
Phone Number* This field is required.
Please enter a valid phone number.
5
Please enter your website link if applicable.
6
Is your company / organization interested in becoming a retail partner with R.A.W. Body Essentials?* This field is required.
Yes
Yes, but I have a few questions
Not at this time
7
Does your company / organization have a social media presence? If so, please check each platform below:* This field is required.
Facebook
Snapchat
Instagram
Twitter
No Social Media
Other
8
Please list any and all of your social media handles:
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Ok
Ok
9
Is your company tax exempt?* This field is required.
Yes (please upload a copy of your certificate next)
No
Not yet
10
Please upload your tax exempt certificate if applicable.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
11
How did you hear about R.A.W. Body Essentials?* This field is required.
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Ok
Ok
12
Are there any specific questions that we may answer for you at this time?* This field is required.
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Ok
Ok
13
By completing this form I acknowledge legal authority to register as a wholesale client with R.A.W. Body Essentials on behalf of the company / organization listed at the top of this form.* This field is required.
I acknowledge
14
Please verify that you are human* This field is required.
Should be Empty: