| | | APPLICATION FOR WHOLESALE PURCHASE OF
CAROLINE BRADLEE DESIGNS
Thank you for your interest in carrying our clothing in your shop. Prior to forwarding you the wholesale prices, you must complete this form, print it, and FAX or MAIL it to us at:
Fax 251.476.0221
OR
Barbara H. Ward
WHOLESALE APPLICATION
Children's Cottage
2504 Old Shell Road
Mobile, Alabama 36607..
1. Name of Store:_______________________________________
2. Name of Owner of Store:________________________________
3. Address of Store:______________________________________
_____________________________________________________
4. Telephone Number:___________________________________
5. Fax Number:_________________________________________
6. Store's Email Address:_________________________________
7. Years in Business Under Present Owner:____________________
8. State Retail License Number:_____________________________
9. Federal Employer ID:___________________________________
10. Method of Payment: ___________Credit Card __________COD
11. If Credit Card, State the Number, Exp. Date, Billing Address (including the zip code), and the CVV Code:
________________________________________________________
________________________________________________________
________________________________________________________
________________________________________
SIGNATURE OF OWNER
Date:___________________________________
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