Business Contact Information
Contact Name*:
First*:
i:
Last*:
Company*:
Address*:
Street*:
City*:
Province*:
Postal*:
Country*:
Phone*:
()ext.
Fax:
()
E-mail*:
Website:
http://
Please provide your Business Registration
Number/Federal ID Number*:
Type of Business
Description*:
Please provide a brief description of your business, indicating whether it is a store or whether you are a manufacturer, jewellery designer, professional crafter. If you are a new business or are planning a business, please describe your goals for the business.
Supplier/Trade References
Reference 1
Company Name:
Contact Person:
First*:
i:
Last*:
Phone:
()ext.
Fax:
()
E-mail:
Reference 2
Company Name:
Contact Person:
First*:
i:
Last*:
Phone:
()ext.
Fax:
()
E-mail:
Reference 3
Company Name:
Contact Person:
First*:
i:
Last*:
Phone:
()ext.
Fax:
()
E-mail:
Optional Additional Information
How soon do you plan on buying?:
What types of products are you interested in?:
Terms & Conditions
I agree to the Terms & Conditions*:
Robert Hall Originals reserves the right to verify the information you provide. If you are not manufacturing or reselling or if you provide false information or invalid trade references, your application will be denied. If you cease to manufacture or re-sell, your wholesale privileges will be rescinded. There is a minimum of $100 Canadian per order. By submitting this application, you are signing up to receive periodic information about new products, new catalogue, specials etc.