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B2B WHOLESALE FORM
PAYMENT METHOD
FBA SHIPMENT
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Wholesale Application
Please fill out the form below to apply for a wholesale account
Personal Information
First Name
*
Last Name
*
Email
*
Phone Number
*
Business Information
Company Name
*
Store Name
*
Business Email
*
Business Website
EIN Number
*
Resale Certificate Number
*
Amazon Store Link
*
Business Address
Street Address
*
City
*
State/Province
*
ZIP/Postal Code
*
Country
*
Business Model
Select Your Business Model
*
Amazon FBA
Walmart
eBay
Retail Store
Online Store
Other
Payment Method
Preferred Payment Method
*
Select payment method
Wise Transfer
Other
Additional Information
How did you hear about our brand?
*
Please select
Google Search
Social Media
Referral
Trade Show
Advertisement
Other
Expected Monthly Volume
*
Select volume
Less than $1,000
$1,000 - $5,000
$5,000 - $10,000
$10,000 - $25,000
$25,000 - $50,000
$50,000 - $100,000
Over $100,000
Expected Annual Revenue
*
Select revenue
Less than $10,000
$10,000 - $50,000
$50,000 - $100,000
$100,000 - $250,000
$250,000 - $500,000
$500,000 - $1,000,000
Over $1,000,000
Document Upload
Upload EIN Certificate (PDF)
*
Choose EIN Certificate PDF
Upload Resale Certificate (PDF)
*
Choose Resale Certificate PDF
Additional Comments or Questions
Submit Application
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