Wholesale Customer Inquiry Form

Wholesale Customer 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.
Name
Phone Number:
Format: (000) 000-0000.
Email Address:
Business Information
Reseller ID #
Business Name
Address
Website
Merchant Type

Other
What best describes your business?

Other
Additional Information
Who is your primary customer?
What are the main product categories available in your shop?
What other body care lines does your store carry?
What other specialty food items does your store carry?
Have you ever visited Los Poblanos?
Have you ever used Los Poblanos products before?
Are you interested in selling Farm Foods, Lavender Collection, or Both?
If you checked “Brick & Mortar” and/or “Multiple Locations” for merchant type, please list the physical address of the store or multiple stores where you would like to retail our products (if the address differs from the one in the field above).

If there are multiple store addresses, please list additional addresses in the provided fields.
Retail Shop / Store Name
Address
Website
Additional Retail Shop / Store Name
Address
Website
Additional Retail Shop / Store Name
Address
Website
Additional Retail Shop / Store Name
Address
Website
Please include any additional notes or information you would like us to know.
Please verify that you are human
Should be Empty:

Wholesale Customer Inquiry Form

Business Information

Additional Information