Wholesale Application
Referred by:
KOZAKH Wholesale Team (In-House Sales)
Susan & Company (Sales Rep Group)
Matdalee Studio (Sales Rep Group)
Other (write in name here):
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What kind of store do you have? (check all that apply)
I own a brick and mortar store.
I am an online retailer.
Other (describe):
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Company Name*
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First Name*
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Last Name*
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Address*
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Address Line 2
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City*
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State
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Zip Code
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Country*
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Year Business Opened*
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Tell us about your store.*
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Phone Number
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Example: +1 (012) 345-6789
Email*
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Password*
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Confirm Password*
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Email me order confirmations & new releases.*