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Wholesale Partner Application
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* Required
Name (First and Last Name)
*
Your answer
Company Name
*
Your answer
Email
*
Your answer
Phone Number
*
Your answer
Billing Address
*
Your answer
Is the billing address the same as the shipping address ?
*
Yes
No
If no, please provide the shipping address.
Your answer
Sales Tax ID # (Please email a copy of your state's resale certificate ST-5 to
sales@xocolatlchocolate.com
.)
*
Your answer
What products are you interested in?
*
Retail products for resale (chocolate bars, trail mix, drinking chocolate, herbal cacao tea, and more!)
Bulk products for food & beverage services (bulk chef's chocolate, tempered or untempered, bulk cacao nibs, cocoa powder, cocoa butter)
Required
Describe your business.
*
Your answer
Any other notes/comments:
Your answer
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