Email Address *

Full Legal Name (First and Last) *

Home Address *

Business Name *

Business Address (if same as home input same) *

Tax ID Number (Optional)

Is your business online, brick and mortar or both? *

How long have you been in business? *

How many products are you looking to purchase monthly? *

What products are you most interested in wholesaling? *

By filling out this form I certify that all information is true and correct. I understand that my application can be declined for any incorrect information. I understand that there is no fee associated with joining the wholesale program and I will only pay for the merchandise that I plan to sale. I understand that Crown Jeweled Bath and Body will provide me with MSRP (manufacture suggested retail pricing) for all items however I can price the items as I see fit. I understand that I am not permitted to alter the products or their ingredients/ formulas in any way. I understand that not following the terms of the wholesale agreement can cause my wholesale privileges to be revoked at any time. *