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Supplier Application
This form is to qualify and determine Holistically Refined's suppliers.

Please note that your products must be made by your company and not resold.

Holistically Refined is committed to being a trusted source for quality natural and holistic products. As a supplier, you are held to a high standard of excellence; that includes providing quality ALL natural ingredients in your products and listing ALL ingredients on your product label.

As a potential supplier with Holistically Refined you must agree to sell to us at a bulk discounted price or wholesale rates. Suppliers that are selected must be credible and reputable.

If you are not selected at this current season, we will keep your application on file to potentially contact you in the future. All suppliers are welcome to become a Provider on HolisticallyRefined.com.

Please fill out the form below with accurate information, so that we may process your application in a timely manner. Thank you.

Business Name *
Your answer
Business Address *
Your answer
Business Days & Hours of Operation i.e., Monday - Friday (9:00 am - 6 pm), Saturday (10:00 am - 4:00 pm) *
Your answer
Business Tax Number/Business ID # *
Your answer
First Name *
Your answer
Last Name *
Your answer
Title *
Your answer
Email *
Your answer
Website *
Your answer
Please select all social media platforms where your business has a presence *
Required
Please list the links to your Business' social media accounts *
Your answer
Number of years in business
How did you hear about Holistically Refined? *
Required
What natural products do you offer? (Please check all that apply) *
Required
Below, please provide us with a short detailed description of why your products or services will add to the quality of Holistically Refined's Platform. *
Your answer
Which is the best way to contact you? *
Required
Are you open to sending us sample products? *
THANK YOU
Thank you for your interest in featuring your services and (or) products with HOLISTICALLY REFINED someone will be in contact with you and your company within 7-14 Business Days.


HOLISTICALLY REFINED, LLC
Connect@HolisticallyRefined.com

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