Miniware Wholesale Application Form

New Wholesale Account Application - Free Sample Request
Business Name
DBA
Intent
Your Name

First NameLast Name
Position
E-mail
example@example.com
Phone Number

Area CodePhone Number
Primary Contact for Orders

First NameLast Name
Email
example@example.com
Phone Number

Area CodePhone Number
Website URL
Store Address

Street Address Line 1

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Shipping Address

Street Address Line 1

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Additional Store Location, if any

Street Address Line 1

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Special Delivery Instructions, if any (or type NONE)
Do you sell on any 3rd party marketplaces?
If yes, please list the URL here:
Reseller Permit Copy

Upload a File
Upload a copy now, or email it to us prior to your first order. Cancelof
Federal Tax ID
Select Your Free Sample Item(s)
Should be Empty:

New Wholesale Account Application - Free Sample Request