#GETFLOATY Wholesale Application

Wholesale Application
Buyer Name*

First NameLast Name
Business Name*
Website
Example: https://www.getfloaty.com/
Social Media Links
Business E-mail*
Phone Number*

Country CodeArea CodePhone Number
Corporate Structure*

Sole ProprietorshipPartnershipCorporationOther
Years in Business*
Business Registration Type?*
Select "other" if type not listed
If "other" is selected above. What is your business registration type?
Leave blank if "other" is not selected as business registration type
Business Registration Number*
Sellers Permit Number*
Where will the products be resold?*
Number of Stores*
Shipping Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Name*

First NameLast Name
Position/Title*
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty: