WHOLESALE APPLICATION

To open a Wholesale account with us, please provide the following information

Company Name

First Name

Last Name

How would you categorize your business?

Briefly describe how you intend to sell our products:

Retail Store Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Company Website

http://

Email Address

Owners/Partners/Officers

First Name

Last Name

Title/Role

Tax ID#

Which GuChet products are you most interested in?

By completing our Wholesale Application and/or placing an order, the buyer agrees to our Terms and Conditions. These Terms and Conditions represent the entire agreement between the buyer. If any provision of these Terms and Conditions are found to be unenforceable or invalid, the remaining provisions shall remain in effect.