Wholesale Account Application

Company Information

Legal Business Name*

Business Registration #*

Years in Business*

Business Address Line 1*

Business Address Line 2

Business City*

Business Province / State*

Business Postal / Zip Code*

Business Country*

Business Phone Number*

Business Email*

Contact Information

First Name*

Last Name*

Position*

Email*

Do you have an online store?*

Yes No

If Yes, Website URL

Do you have physical store?*

Yes No

If Yes, Location

How often do you order merchandise?*

How did you hear about us?*

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