Fusion Mineral Paint Retailer Application

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

First Name *

Last Name *

Email Address *

Phone Number *

Are you a brick and mortar or a booth in a market?

Brick and mortar

Booth in a market

Other:

Required

If you are a booth in a market, are you a vendor at the market or do you own the market?

Vendor

Own the market

Not applicable

Other:

Store Name: Please provide the exact store name as this will be listed on our map. If you are a booth inside a market, please provide the exact name of how it should appear. E.g., Bob’s Treasures @ Georgia’s Antique Market.

Address of where you will be selling the products (including city/town, state/province and zip code/postal code).

If you have a store on your residential property, is it properly zoned for commercial use and do you have the paperwork to support that.

Yes

Not applicable

Other:

Provide a Facebook page link to your business or your website.

Tell us a little about your store such as if you already carry a paint line, do you hold workshops, how did you hear of Fusion, how long have you been in business.

Are you taking over a current Fusion retailer’s location.

Yes

Other:

If you are a current retailer, are you moving?

Yes

Not applicable

Other:

If you are a current retailer, are you opening a second location? *

Yes

Not applicable

Other...

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Forms