PIPA Wholesale Application

Wholesale application

for PIPA Fashion Inc.
Business Details
Your Name*

First NameLast Name
Company/Business Name*
Tax ID / HST number
Seller's Permit / Certificate of Incorporation*

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please provide at least 1 valid document to verify your business Cancelof
Tell us about your business' story, and what products and sizes you're interested in purchasing from us:*
Your Website
where sell or you plan on selling products
Facebook
where you'll be selling or promoting products
Instagram
where you'll be selling or promoting products

Contact Information
Business E-mail*

Confirmation Email
Business/Shipping Address*

Street and Number

(app., suit, et.)

CityState / Province

Postal / Zip CodeCountry
Phone*
How did you hear about us?*
Disclosure*

I hereby state that, to my knowledge, all information submitted here is correct and that I intend on becoming a wholesale customer of PIPA Fashion Inc. I will NOT share any proprietary information given or shown to me (including prices, styles, images, etc.) with any other party without written consent by PIPA Fashion Inc.
Your e-Signature*

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Wholesale application