JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Luxe B Co Wholesale Account Application U.S. & Canada
Thank you for your interest in selling Luxe B Co
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Company Name
*
Your answer
Full Name
*
Your answer
Shipping Adress
*
Your answer
Phone Number
Your answer
Cell Phone Number
Your answer
EIN Number (USA)
Your answer
GST Number (Canada)
Your answer
If you have an online storefront, please provide your web address.
*
Your answer
How many employses at your company
*
less than 2
2-5
5-10
10-15
15 +
Is your store online-only? NOTE: We cannot accept orders from those who sell on third party websites-including but not exclusive to Amazon, eBay, etsy ect.
*
Yes
No
Required
How many years in business
*
Less than 1
1-3
3-5
5+
Additional Store Locations
Your answer
Billing Address
*
Your answer
Tax exception - Do you have reseller certificate , if so please select yes and we will email you to place it on file.
*
Your answer
How would you categorize your store?
General gift
Home decor
Clothing boutique or apprarel
Grocery or pharmacy
Spa
Other:
Other:
Clear selection
How did you hear about us?
*
Instagram
Facebook
Online search
Google
High Point
Atlanta Market
Shoppe Object New York
Faire
Other:
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of luxebpampasgrass.com.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report