Dealer Application
Business Name:
First Name:
Last Name:
Business Address:
City:
State:
None
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington D.C.
West Virginia
Wisconsin
Wyoming
Zip Code:
Country:
Phone:
Fax:
Email:
Website:
Tax ID #/ Resale #:
Where do you sell your products? Please Check all that apply:
Brick and Mortar Store
Classes
Mail Order Catalog
Shows
Website
Etsy
Artfire
Other
Years in Business
Please further describe your business method of distribution:
