Wholesale Inquiry

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* 1. Full Legal Business Name*

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* 2. DBA Name (If this is the same as your Legal Business name, please leave blank)

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* 3. Main Contact Information*

Main Contact First Name

Main Contact Last Name

Main Contact Phone Number

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* 4. Main Contact Email

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* 5. Shipping Address*

Address

City

State

Zip Code

Country

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* 6. Billing Information

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* 7. How many brick & mortar locations do you have?

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* 8. Check which type of company is applicable to you*

Corporation

General Partnership

Limited Partnership

LLC

Sole Proprietorship

Non-Profit

Other (please specify)

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* 9. Federal ID#: *If you do not have one, please type N/A

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* 10. Dun & Bradstreet Reference #:*If you do not have one, please type N/A

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* 11. On Which of the Following Online Sites Do You Currently Sell On? (Check All That Apply)*

Company Website

Amazon

eBay

Alibaba

Target.com

Walmart.com

Not Selling or Planning to Sell Online

None of the above

Other (please specify)

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* 12. Website URL - if you don't have one, please type N/A*

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* 13. Who are your customers? (Check all that apply) *

End Consumer

Retailers

Distributors

Other (please specify)

Wholesale Inquiry

Question Title

* 1. Full Legal Business Name*

Question Title

* 2. DBA Name (If this is the same as your Legal Business name, please leave blank)

Question Title

* 3. Main Contact Information*

Question Title

* 4. Main Contact Email

Question Title

* 5. Shipping Address*

Question Title

* 6. Billing Information

Question Title

* 7. How many brick & mortar locations do you have?

Question Title

* 8. Check which type of company is applicable to you*

Question Title

* 9. Federal ID#: *If you do not have one, please type N/A

Question Title

* 10. Dun & Bradstreet Reference #:*If you do not have one, please type N/A

Question Title

* 11. On Which of the Following Online Sites Do You Currently Sell On? (Check All That Apply)*

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* 12. Website URL - if you don't have one, please type N/A*

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* 13. Who are your customers? (Check all that apply) *

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* 14. What do you consider your market to be?