To contact us:

mm

Wholesale Account Application

(please print)

 

Company name_______________________________________________________________

Company Address         __________________________________________________

                                         City____________________________State__________Zip_________

Contact Name________________________________________________________________

Shipping Address          __________________________________________________

                                   City____________________________State__________Zip_________

Business Phone(                  )______________________________________________________

Cell Phone           (                )______________________________________________________

Fax Number        (                )______________________________________________________

Email Address ________________________________________________________________

Resale Tax Number ____________________________________________________________

Type of Business

(check all that apply)

__Pet superstore                         ___Independent Pet Shop                    ___Department Store

__Veterinary Clinic                                __Dog Spa                                     __Pet Boutique

__Wholesaler                                          __* EBay Seller                                      __Groomer

__Gift Shop                                   __**Internet Retailer             Other_________________

* EBay Name__________________________________

** Website Address ____________________________

 

Signature ____________________________________Date _______/________/________