WHOLESALE Application FORM

THANK YOU FOR YOUR INTEREST IN CARRYING

If you have read and accept our wholesale terms, please fill out this form so we can learn a bit more about you!

Feel free to contact us at sales@cynthiakingdance.com with any questions.

Name

First Name

Last Name

Email Address

Phone

Country

(###)

###

####

Federal Tax ID#

Business Description

(Check all that apply)

Dance Studio

Brick and Mortar Store

Web Store

Business Name

Website

http://

Business Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country