Wholesale Vendor Request Form
Business Name/ Nombre de Negocio:
*
Business Type/ Tipo de Negocio:
*
Salon
Beauty Supply/Tienda de Productos de Belleza
Online Store/Tienda en Linea
Amazon
Other
Website/ Pagina de Web:
*
Contact Name/ Contacto:
*
First Name
Last Name
Email/Correo Electronico:
*
example@example.com
Phone Number/Telefono:
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Any other details you would like us to know?:
Please provide a copy of your Reseller Permit (U.S. Businesses):
*
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