wholesale application

Wholesale account application form

Please tell us about your business as much as possible, so that we can better serve your needs and can promptly designate you as a valid wholesale account. Incomplete forms submitted may be delayed until they can be verified as a genuine reseller.
Business name: *
Name:*

First NameLast Name
E-mail:
Phone number:*
Fax number:
Valid resale tax#:*
Type of business:*
ex. leather store, gift, apparel, retail, online etc.
Details about your business:
Open since: *

MonthDayYear
Business website:
Shipping Address: *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Billing Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
User name:*
Password:*
How do you know about us

Google searchFriendsTrade showOther
Should be Empty:

Wholesale account application form