Retailer Application

Retailer Application Form

To begin your application process, please complete the form below. You can also download a PDF version here: Retailer Application pdf

Fields marked with * are required.

* Indicates required field

Business Name *

Contact Name(s) *

Email *

Alternate / CC Email *

Primary Phone Number *

Cell Phone Number *

Shipping Address (no PO boxes) *

Line 1

Line 2

City

State

Zip Code

Country

Mailing Address Same As Shipping Address? *

Yes No

Mailing Address (if different from Shipping Address) *

Line 1

Line 2

City

State

Zip Code

Country

Business Number / Tax Number *

Your Website *

Please briefly describe your business (Gift Shop, Furniture Store, Designer, etc.) *

Preferred transport carrier (if any) *

Your location is: *

Owned Rented

Year Business Was Established: *

Receiving Hours *

Submit this form with confidence -- we will never share your information!

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