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Wholesale Application
​ 

​Date:_________________________________
 
Legal Name of Company/Corporation:_____________________________________________
 
Store Name/DBA Name (if different):______________________________________________
 
Business Owner:___________________________ Contact Person: _______________________
 
Billing Address:______________________________________________________________
                       (street)
______________________________   ___________________   __________________
(city)                                                (state)                        (zip)
 
Business Phone:__________________________________ Fax:__________________________
 
E-Mail:___________________________________ Website: ____________________________
 
Federal EIN: _________________________ Sales Tax #: __________________ State: _______
 
Payment Preference: Visa: ____ MasterCard:____ AmEx____ Discover____ Check: ____ Money Order: ____ Paypal:______(Paypal Email Address:__________________________)
 
Credit Card Information:
Name (Exactly as it appears on card):
________________________________________________
 
Card Number:____________________________ Expiration:____ /____ CVV: __________
 
Signature authorizing card billing at time of shipment (required): _______________________________________
 
Type of Business:
Independent Retailer:_________
Small Chain (less than 5 stores): __________
Home Based Business: _____________
Internet: __________
Other: _____________ Please Explain: _____________________________________________

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  • Home
    • About The Soapery
    • Contact The Soapery
  • Whats In Side
  • Wholesale
  • Blog
  • FAQs & Policies
  • Press
  • Reviews