First Name*
Last Name*
Job Title/Function
Phone Number
Ex. (401-941-9599)
Fax Number
Email Address*
|
Website
Name of Company / Business
Name of boutique, spa, etc, if different
from Company
/ Business Name
Tax ID Number or FEIN Number
Resale ID Number
You will be required to mail or fax a copy
of your
resale ID certificate. |
Contact Name / Store Manager
Address Line 1
Address Line 2
City
State
Province
|
Country
Zip/Postal Code
Phone Number
Ex. (401-941-9599)
Fax Number
Email Address
|
Primary Business Category (select one)
Other
Location
Other
Location Type
Square Footage of Retail Shop
Number of Locations
If more than one location, describe
any additional locations
using the criteria above
Date Retail Shop Opened
(mm-yyyy)
If Not Yet Open, Opening Date (mm-yyyy)
|
List other retail outlets or major
stores near
your location
List products and brands that you carry
How did you hear about Aurora Pet Products?
Comments and questions?
|
Genuine
Sheepskin