Wholesale Application

Wholesale Application for Consideration
Company Name *
Eg. A1-Flag Distributor, LLC.
Primary Wholesale Coordinator, Purchaser, Buyer*

First NameLast Name
E-mail Address*
example@example.com must be a business email no personal or group emails Wholesale@co.com or Admin@co.com No *@gmail.com, *aol.com, *@yahoo.com *@hotmail.com must be a registered domain for your organization to be considered.
Phone Number*
Address - Legal Business Location *

Street Address

Street Address Line 2

CityState

Zip Code
Do you have a current Reseller Certificate

YESNO
Reference Account Email
example@example.com Who can we contact that you currently do buy products with.
Please provide a brief description the reason you think you would be a great wholesale customer for Carrot-Top Industries. Please include as much detail to support your application for consideration include past history of sales, projected sales, current suppliers. Once complete we will review and be in touch with our decision. *
Should be Empty:

Wholesale Application for Consideration