Wholesale Inquiry

Please Fill out our Wholesale Application and email to: earthselements@hotmail.com

We will then get back to you with Wholesale price list. Thank You for your Interest!

 Earths Elements Wholesale Application

Shop Name:_____________________________________________________

Contact:________________________ Phone:__________________________

Email:__________________________________________________________

Website:________________________________________________________

Address:________________________________________________________

City:_____________________________ State:_______ Zip:_______________

Resale Tax ID:___________________________________________________

Shipping Address:________________________________________________

City:_____________________________ State:________ Zip:_____________

Tell us about your store:___________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________

How did you hear about us?:_______________________________________

______________________________________________________________

______________________________________________________________

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