Wholesale Account Application -- Cariloha

Wholesale Account Application
Brand
Completed By*

First NameLast Name
Email of Submitter*

Company Information
Company Name*
DBA Name (If Different)
Parent Company Name (If subsidiary)
Contact Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*
Email*
Type of Business*

CorporationLLCPartnershipProprietorship
Resale Certificate Number
Resale Certificate Expiration Date
Upload Resale Certificate

Browse Files

Cancelof
Are you a member of a buy group?*

YesNo
Please specify which buying group:
Do you have physical storefronts?*

YesNo

Billing Information
Billing Address Same As Primary?

YesNo
Billing Name
Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Phone Number
Email

Contact Information
Buyer
Name

First NameLast Name
Email
Phone Number
Accounts Payable
Name

First NameLast Name
Email
Phone Number
Shipping Notifications
Name

First NameLast Name
Email
Phone Number
Notifications Via Email?

YesNo
Warehouse
Name

First NameLast Name
Email
Phone Number

Shipping Preferences & Compliance
Do you have shipping compliance requirements? **(If you are not absolutely positive, please select 'I Don't Know' and a member of our team will be in touch to discuss more. Shipping compliance is having special requirements pertaining to the lift gate, dock, deliver appt., palletized shipments, etc.)***

YesNoI Don't Know
Routing Guide?

YesNo
URL for Routing Guide
Will you be using your own billing account for shipping?*

YesNo
Notes/Additional Comments

Terms and Conditions
Terms and Conditions
I agree to the Terms and Conditions
Quality Control Standards
I agree to the Quality Control Standards
Brand Protection Packet
I agree to the Brand Protection Standards
Signature*

Clear
Should be Empty: