Wholesale Account Application
Hi! Thank you for your interest in applying for a wholesale account with The New Primal! We look forward to receiving the following information so that we can best assist you!
What is your name? *
What is your email address? *
What is your shipping address? *
What is the name of your business? *
Does your business sell domestically or internationally? (*PLEASE NOTE: We are not exploring international opportunities at this time.*) *
Are you an online retailer, or brick and mortar establishment? Or both? *
If you are a brick and mortar establishment, please list the city and state of each location. *
What products are you interested in purchasing through our wholesale program? *
How much do you plan to order? *
How often do you plan on ordering these quantities? *
Clear selection
Never submit passwords through Google Forms.
This form was created inside of The New Primal, LLC. Report Abuse