Wholesale Application

Please complete the following steps to register for Alchemilla's Retail Distribution Program:

1. Complete and submit the form below.
2. Fax a copy of your current Reseller Permit or Business License to: (503) 914-0883**.

** To qualify for an Alchemilla wholesale account, businesses are required to provide at least one proof of business, ie.: (Current) Resellers Certificate and/or (Current) Business License as described above. We must be able to verify business addresses. Please note that the approval process cannot commence until the above requirements are met. Please allow up to 3 business days for a response. Thanks!

* Contact Name :
* Business Name :
* Business Type :
* Vendor Permit/License # :
* Contact Email :
Web URL :
* Business Phone :
* Business Address :
* City :
* State :	Select... AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
* Zip :
* Preferred Contact Method :	By Phone - Morning By Phone - Afternoon By Phone - Evening By Email By Fax
* Please tell us a little about your business :
(On hitting 'submit' you may automatically receive a newsletter 'opt-in' email. If you do not wish to be added to our mailing list, simply ignore the email).

 

Consumers cannot buy from Alchemilla at wholesale price, but they can buy from our online store at www.myalchemilla.com.