Rosalina Account Application
Thank you for your interest in Rosalina Baby Collections, Inc. products. Please fill out all fields applicable.
Email Address *
Please provide a VALID email address that you access on a frequent basis, so that we can contact you about your account.
Your answer
Company Name *
Your answer
Store Owner Name (First. Last) *
(person responsible for account)
Your answer
Customer Account # (if updating information on existing account)
Your answer
Billing Street *
Please provide the address to where you will receive billing.
Your answer
Billing City *
Your answer
Billing State *
Your answer
Billing Zip *
Your answer
Shipping Same as Billing? *
Shipping Address (if not the same as billing)
Please provide the address to where we will ship your orders. (this must match your retail license)
Your answer
Contact Phone Number *
This is the phone number we will reach you for all business matters. (xxx) xxx-xxxx
Your answer
Store Phone Number
If you would like to provide a store number that is different from your contact phone number. (xxx) xxx-xxxx
Your answer
Website Address (URL)
must have "http:" ie. http://www.rosalinababy.com
Your answer
Facebook Page Address (URL)
must have "http:" ie. http://www.rosalinababy.com
Your answer
Other Social Media or Auction Site to Note (list all that are applicable)
Your answer
Please include any additional information about your store/company that would help us know you.
Your answer
For our record, please check the statement(s) below which best describe your store. *
For full line account, please submit pictures of your store (inside and outside with permanent signage), a copy of your state sales tax license or certificate to info@rosalinababy.com. If you do not have a physical location, you can omit the pictures.
Required
Uniform Sales and Use Tax Certificate *
Please choose the state you are licensed to sell:
Retail Tax License # *
Please enter your retail tax license number. If you do not have your license number available, you can enter "00000" and provide it later. Please note that your application and/or orders will not be processed without this information.
Your answer
Retail Tax License - Address *
Your retail tax license address should be the same as your shipping. If it is different, please indicate. Please email a copy of your retail license to info@rosalinababy.com
Different address on Retail Tax License
If retail tax license address is different from your shipping address, please provide below and explain. Skip this question if your shipping and retail tax address match.
Your answer
Retail Tax Agreement *
Required
Rosalina® Product and Model Photography *
Required
No Auction Sites Compliance *
Required
Retail Markup *
Required
Sales Terms and Conditions *
Rosalina account qualification will be based on the information and pictures submitted. If in any reason, your store information changes and becomes different from the original application, Rosalina, Inc. must be informed immediately via email, mail or fax. In failing to do so, your open/future order may be delayed. Any change on your account information may modify your classification status. Once we received all of the above information, please allow 2-4 days to process your account. We will send you an e-mail notification regarding the status of your application. Please take a moment to read our Sales Terms & Conditions (a copy of these terms will be emailed to you upon submission of the application). For further information, please contact our customer service department at 843-871-8438 ext. Rosalina reserves the right to reevaluate,reclassify, and/or change your account status. We also reserve the right to refuse an order. Again, we thank you for your interest in Rosalina products.
Required
Please tell us how you heard about Rosalina® Baby Collections: *
Digital Signature *
By placing your initials in the box below, you agree with the Sales Terms and Conditions.
Your answer
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