Wholesale Registration Page

First Name *

Last Name *

Phone *

Email *

Company Name *

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Address 1 *

City *

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Postcode *

Password *

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AboutCompany *

Current Retail Locations (optional) 12345more than 5

How did you hear about us-referred by (optional)

Location of stores *

Number of years in business * 12345 or more

Other lines (optional)

Account Manager / Rep *

EIN / Resale License *

Store Average Price Point *

Type of Retail Store (main focus – jewelry, kids boutique, home furnishings, women’s boutique, etc.) *

Website (optional)