Gianna Rose - New Customer Application

ONLINE WHOLESALE APPLICATION

Please submit the following information to apply for a wholesale account with Gianna Rose Atelier. You should also review the Wholesale Terms, Conditions and Policy on Website Operations and Use of GRA Images. Customer Care will respond to your request as soon as possible.

Gianna Rose Atelier products are designed to be merchandised in high-end, gift, personal care, fashion, home furnishing, and accessory retail store environments. In addition to completing an application to become a wholesale customer, a visit to your retail establishment, by a Gianna Rose Atelier sales representative, will be required.

I have reviewed the Wholesale Terms and Conditions and agree to them.

Company:	(maximum 50 characters)
Resale No.:	(maximum 25 characters)
First Name:	(maximum 15 characters)
Last Name:	(maximum 25 characters)
Phone:
FAX:
Email:
Password:	(Must be 4 to 10 characters)
Email list?	Yes, add me to the Gianna Rose Atelier Email list!

Bill to:
Address:
City:
State/Prov:	(Inside US & Canada)
Foreign:	(Outside US & Canada Only)
Zip Code:	(Zip Code or Postal Code)
Country:

Ship to:	Check if same as Billing
Address:
City:
State/Prov:	(Inside US & Canada)
Foreign:	(Outside US & Canada Only)
Zip Code:	(Zip Code or Postal Code)
Country:

Business Profile:

1.	Are you an existing Gianna Rose Customer?
	Yes No
	If Yes, Please Enter Gianna Rose Customer Number: (Please email customercare@giannarose.com or call 888.544.2662 to obtain your customer number if uncertain).
If you are an existing Gianna Rose Customer, you are not required to answer questions 2-5 below.
2.	Do you have a store front?
	Yes No
	If No, Please Explain Type of Business:
	If Yes, Square Footage of your Retail Store:

3.	Type of Products Sold:
4.	How long have you been in business? 0-1 year 1-3 years 3-5 years 5-10 years 10+ years
5.	How were you referred?

All Gianna Rose Atelier® Soap Products are made in the USA (except soap petals which are made in the Netherlands).