Wholesale Inquiry Form
Company Name:
*
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Shop Address (including city, state, and zip):
*
Website:
Do you currently have a valid retail certificate?:
Yes
No
What kinds of products do you currently offer?:
Where did you first learn of Fire & Pine?:
Do you operate multiple locations?
Message
How would you prefer for us to contact you?
Email
Phone call
Text message
Zoom/FaceTime
*
I understand I am applying for a wholesale account with Fire & Pine and approval is based on review of my account.
Submit
Should be Empty: