Wholesale

PLEASE FILL OUT THIS FORM FOR ALL WHOLESALE INQUIRIES AND A
REPRESENTATIVE WILL GET BACK TO YOU WITHIN 24 HOURS.

Company/Business Name:

Business Type, (I.E Salon/Beauty Supply Store/Online Retailer):

Number of Locations:

Address:

City:

State / Province:

Postal / Zip Code:

Country:

Phone:

Fax:

ALTERNATE PHONE:

Email:

Owner Name(s):

Authorized Buyer Name(s):

Website (if applicable):

Social Media Sites:

How did you hear about us?:

Shipping Address:

City:

State / Province:

Postal / Zip Code:

BILLING ADDRESS:

City:

State / Province:

Postal / Zip Code:

Federal Tax ID:

Reseller #:

How Long have you been in business?:

Store/Salon Hours:

Do you have an online store, brick & mortar or both?:

Online store Brick & Mortar Both

A copy of your business license is required with this application, please upload it below:

I certify that the information provided on this form is truthful and complete.

Please type your name below:

Date: