MakeYourOwnBirdToys.com

Wholesale Account Application

Business Name: __________________________________________

State Tax Resale # ___________________

Type of Business: (check one)

□   Retail Store Front

□   Online Retailer   (Website URL: __________________________)

□   Bird Toy Manufacturer

□   501 (3)(c)

□   Other (explain) ________________________________________

 

Owner's Name: ___________________

Business Phone:   (        ) -_______________

Days & Hours of Operation: ________________Email Address: ____________

Mailing Address: _________________________________________________

City: ________________  State:  ______  Zip: ________   

Shipping Address: ________________________________________________

City: ________________  State:  ______  Zip: ________   

I have read the terms and conditions of wholesale accounts and certify that I meet the requirements:

Signature of Owner/Manager: __________________________   Date: ________

Print Name: _________________________________________   Title: ________