If you're interested in opening a wholesale account with us or would like to receive further information about our product line, please complete the following questionnaire. Please expect a response within 48 business hours.
Required items are indicated in bold.
Company Name:
Bill-To Address Line 1:
Bill-To Address Line 2:
City:
State(2 Ltr)/Province:
Postal Code:
Country:
Resale Certificate #:
Attach Resale Certificate:
Years in Business:
Phone Number:
Fax Number:
E-mail:
Your First & Last Name:
Your Title:
Website:
Have you every purchased from Magnolia Lane Flags?:
Yes
No
Anticipated Yearly Purchases of our Product Line:
Under $500
$500 - $1,000
$1,000 - $2,500
over $2,500
Shipping Location
Residential Address:
Yes
No
Store Name
(If different than above)
Ship-To Address Line 1:
Ship-To Address Line 2:
Ship-To City:
Ship-To State(2 Ltr)/Province:
Ship-To Postal Code:
Ship-To Country:
Ship-To Phone Number:
Ship-To Fax Number:
Ship-To E-mail:
Type of Business:
(check all that apply)
Arts & Crafts
Book
Department
Catalog
Educational
Farm
Florist
Furniture
Gift
Garden
Hardware
Museum
Nature
Pharmacy
Website
Other
(Please enter below)
Where did you learn
about our products?
Are you interested in
a particular product or
product line?
Quick Note:
Prospective Wholesale Customer Information
