WHOLESALE DEALERS - Application Form



Store/Trade Name
Official Corporate Name
Name of Person to Contact/Owners
Address of Outlet
Outlet City
Outlet Province/State
Phone Number
Fax Number
Type of Business
Square Footage
Email Address
Number of Stores
Other Authorized Buyers
Purchase Order Numbers Required On All Orders
Invoicing Instructions (number of copies, shop by purchase order only, mailing, authorized signature)
Registered Business Country, Province or State
Years In Business
Months Of Year Open For Business
Business License # or Tax ID #
Comments

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