Please fill out the form below to apply for a wholesale account. If you need some assistance, a little hand along the way, feel free to give us a ring 805-220-6509 or toll free at 877-724-5434. It is our promise that we will offer you the best service imaginable. Once form is submitted, someone will contact you within 72 hours. Much success with Waxing Poetic!

Retailer Registration Form
* required field

Are you a? *

New Retailer Current Waxing Poetic Retailer

Store name *

Type of store *

Brick & Mortar Online Brick & Mortar and Online Catalog Other - explain below

Resale No. *

First Name *

 

Last Name *

Title *

How did you heared about us? *

Retail store Friend Fashion magazine Trade magazine Google Yahoo MSN Tradeshow Other

Billing

Address 1 *

Address 2

Bill To City *

State/ Province *

Postal Code *

Country *

Phone *

 

Fax *

 

Email *

Website

Other type of store *

Other *

Ship to

Business name

Address 1

Address 2

City

State/ Province

Zip Code

Country

Phone

 

Fax

 

Email

ATLANTA
Mini Market
March 15-17, 2013
Atlanta International Gift and Home Furnishings
July 10-17, 2013
Tango
Bldg 2 #1000B
404-522-8090 ph

DALLAS
Mini Market
March 21-24, 2013
Dallas Total Home and Gift Market
June 19-25, 2013
Portico
WTC #576
214-757-9055

CHICAGO
Mini Market
April 8-9, 2013
Gift and Home Summer Market
July 18-23, 2013
Casa Bella
Merchandise Mart #13-616
630-455-5900