Wholesale Account Application

COMPANY CONTACT INFORMATION

Name of Business:

Street Address:

City:

State:

Zip:

Phone:

Fax:

Website Address 1:

Website Address 2:

Website Address 3:

User Name(your email address):

Password:

*Password must be between 8 and 20 characters starting with a letter and containing only letters and numbers

Brief Description of Business Type (Gift Shop, Web Only, etc)

Product Line (General Merchandise, Wedding Gifts, etc)

STATE TAX ID#:

FEDERAL TAX ID#:

MANDATORY: (Please attach Sales Tax Exepmtion/Resale Certificate or Multi-State Resale Certificate Form)

Date Business Established:

Length of Present Ownership:

Owner’s Name(s)

Name:

Merchandising Categories (picture frames, gifts, hard goods, all, etc.)

Phone:

Fax:

E-Mail Address:

Please check your preferred method of contact:

(best time ___ am/pm)

I agree to the Terms and Conditions

Send