Handmade Natural Cosmetics

Application to Become A Wholesaler

First Name

Last Name

Email address

Company Name

Company URL

Position

Phone

Physical Address

Street Address

Address Line 2

Town/City *

State / Province / Region *

ZIP / Postal Code *

United States (US)

Country

Is your shipping address the same as above?

Yes, It is the same

No, It is different

Federal Tax ID Number

Resale Certificate Number (Optional)

*Sales tax will be charged unless a valid resale certificate number is provided*

Years in Business

Where do you intend to sell our products?

Username

Password

Enter Password

Confirm Password

I acknowledge and agree with the Reseller Terms & Conditions.