Wholesale

Please complete the following information to be processed for a ws/retailer account. When you are finished, just hit the "Send email" button at the bottom of the form to send us your info!

Note: Fields denoted with an asterisk (*) are required.

Thank you for your interest in Tot Dots™.

Wholesale Application

Store Name *

Resale # *

Contact Name *

First

Last

Title

Email *

Web Site

Please provide your URL if you will be selling Tot Dots items through an online store.

Phone *

###

####

Fax

###

####

Address *

Street Address
Address Line 2
City	State / Province / Region
Postal / Zip Code	Country

Credit References

Please provide at least one credit reference below. If you cannot, please provide a short explanation below.

Company

Contact Name

First

Last

Email

Phone

###

####

Fax

###

####

Address

Street Address
Address Line 2
City	State / Province / Region
Postal / Zip Code	Country

Credit Reference #2

Company

Contact Name

First

Last

Email

Phone

###

####

Fax

###

####

Address

Street Address
Address Line 2
City	State / Province / Region
Postal / Zip Code	Country

Credit Reference #3

Company

Contact Name

First

Last

Email

Phone

###

####

Fax

###

####

Address

Street Address
Address Line 2
City	State / Province / Region
Postal / Zip Code	Country

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Wholesale

Credit References

Credit Reference #2

Credit Reference #3