GOODMAMA, INC. APPLICATION FOR WHOLESALE ELIGIBILITY

Please fill out completely and return to: wholesale@thegoodmama.com or fax to 801-704-0891.

First Name

Last Name

Company Name

Full billing and shipping address(es) including country



Phone Number

Fax Number

Email address

Web address

How long have you been in business?

Internet only/Brick & mortar only/both?

Internet store URL?

Brick & mortar stores: Please attach a photo of the inside and outside of your store including storefront sign.


# of retail locations

How did you hear about us?

Resale number

Please include two other products that you carry and references/contact information for these suppliers:

Product

Reference Name

Phone Number


Product

Reference Name

Phone Number


We do not do co-ops and absolutely no co-ops will be allowed.