Wholesale Registration Form

Company Name *

Entity Type * Select Entity TypeProprietorshipPartnershipCorporationLLC

Billing Address *

Billing Address Line 2 (optional)

City *

State * Select StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Postcode *

Is your shipping address different than above? *  Yes  No

Shipping Address (optional)

First Name *

Last Name *

Phone *

Fax (optional)

Email *

Company Website (optional)

How many years have you been in business? *

How did you hear about Foxglove Fiber Arts? *

Other Officers/Company Personnel (optional)

State Business License or State Resale Number *

Business License and/or Tax Resale Certificate *

Optional Secondary Documentation

Authorized Signature *

Date *

I understand that if my initial order is not placed within 6 months of account approval, Foxglove Fiberarts Supply will delete my data for my security. * 

I understand that after 12 months without orders, my account will be marked inactive and I will be removed. * 

I understand that in order to maintain my wholesale account, I must purchase approximately $400 per year. * 

I understand that orders placed online are estimated totals. Once my order has been processed, the total weights and actual shipping costs will be adjsted before my final payment is processed. *