Wholesale Intake
Thank you for your interest in purchasing our products! Please fill out the information below and we'll be in touch notifying you of your acceptance and wholesale discount.
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Contact Name: *
Contact Title (Owner, Manager, etc.):
Contact Phone Number: *
Contact Email: *
Business Name: *
Business Legal Name:
Business Owner Name: *
Business Owner Phone Number:
Business Owner Email:
Business/Shipping Address: *
Tax ID Number: *
Products and Quantities Requested:

*
Other notes:
Questions? Email candy@greenstreetlux.com
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