Wholesale Application Form

Section 1: Company Information

Company Name:*

Company Phone #:

Company Addresss:

Company Address2:

Company City*:

Company State/Territory*:

Company Zip/Postal Code*:

Company Country*:

Company Website URL*:

Tax ID*:

Years in Business*:

Brands Carried:

Social Media Handles + Platforms (ex. Instagram @bumkinsbaby)*:

Main Contact First Name*:

Main Contact Last Name*:

Main Contact Job Position*:

Main Contact Email*:

Main Contact Phone*:

Secondary Contact First Name:

Secondary Contact Last Name:

Secondary Contact Job Position:

Secondary Contact Email:

Secondary Contact Phone #:

Where do you intend on selling Bumkins products?*:

If you intend to sell on marketplaces, which one(s)?

Where do you intend to sell and ship product?

If you intend to sell or ship internationally, which countries? List below:

Estimated Annual Order Volume*:

Anything else you want us to know?