Become a stockist!
If you are interested in carrying Province Apothecary in-store or online, please fill out the following information and we will get back to you as soon as possible.
Store Name *
Contact Name *
Contact Phone #
Contact Email *
Location/Shipping Address
Tell us a bit about your store!
What other beauty brands do you currently carry?
What kind of products are you interested in stocking?
How did you hear about Province Apothecary?
Never submit passwords through Google Forms.
This form was created inside of Province Apothecary.