Dropshipping Registration Form
Customer Details:
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
*
example@example.com
How did you hear about us?
*
Please Select
Newspaper
Internet
Magazine
Other
Please Specify
*
Are you interested in purchasing wholesale or exploring dropshipping options with us?
*
Wholesale
Dropship
Do you currently run your own boutique?
*
Yes
No
What is the name of your boutique?
*
What is your website?
*
Do you own a brick-and-mortar?
*
Yes
No
If yes, what is your store address?
List product categories you are selling on your website and physical store. What is your main selling product?
What pricing range do you sell on your website?
*
From $1 - $50
From $51 - $100
From $101 - $500
From $501 and up
What platforms or channels do you utilize to reach and engage with customers?
*
Can you outline your strategy for driving traffic to your online store or platform?
*
Can you provide insights into your target demographic and how Le Réussi® products fit their preferences?
*
Are you able to adhere to Le Réussi®'s branding guidelines and maintain a consistent brand image?
Yes
No
Submit
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