Applications for wholesale

Application for Accounts

Mellona Artisanal Products Inc.
What is the name of your company?*

0/50
Your Full Name*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How Long has your company been in operation*

Less Than 1 YearMore than 2 Years
Does your company have a retail store?*

YesNo
Is your company currently working with another honey or jam supplier?*

YesNo
If so what is the company name who you are currently working with:*

0/300
Is your company interested in only wholesale pricing or to open an account for credit ?*

Wholesale pricing onlyWholesale pricing and credit account as well
Are you looking to be a authroized reseller or distributor?*

Wholesale pricing onlyReseller or distributor
Any Comments or questions:

0/300
Should be Empty:

Application for Accounts