Wholesale Inquiry Form

Wholesale Inquiry Form

1318 4th St. NW, Albuquerque, NM 87102 | lavender@lospoblanos.com
Los Poblanos is currently seeking retail partners to sell our artisan product lines including our Lavender Body Collection and Farm Foods. We partner with select shops, hospitality properties and spas across the country and around the world that share our aesthetic and respect for authentic, hand-crafted quality.
Contact Information
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Company Information
Reseller ID #
Company Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Website
Merchant Type

Brick and MortarMultiple LocationsEcommerceAmenitiesSubscription BoxBusiness GiftingOther
What best describes your business?

HotelSpaGift StoreRestaurantCoffee Shop / CafeGrocerOther
Additional Information
Who is your primary customer?
What are the main product categories available in your shop?
What other body care lines do you carry?
What other specialty food lines do you carry?
Have you ever visited Los Poblanos?

YesNo
Have you ever used Los Poblanos products before?

YesNoNot Sure
Are you interested in selling Farm Foods, Lavender Collection or both?

Farm FoodsLavender CollectionBoth
If you checked “Brick & Mortar” and/or “Multiple Locations” for merchant type, please list the physical address of the store where you would like to retail our products. If there are multiple store addresses, please list additional addresses below.
Retail Shop/Store Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Website
Additional Retail Shop/Store Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Website
Additional Retail Shop/Store Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Website
Additional Retail Shop/Store Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Website
Additional Notes
Should be Empty:

Wholesale Inquiry Form

Contact Information

Company Information

Additional Information