Pottery Mfg Wholesale Trade Registration Form

For Wholesale Trade Only: to receive our price lists, please submit the following form:

Name: Name: First Last
Name of Business:
Type of Business:
Business Street Address Business Street Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone - ### - ### ####
Email
Do you have a Reseller #?

Do you have a Reseller #? Yes No
Seller's Permit Number
How did you hear about us?

How did you hear about us? Trade Show TV Freeway Sign QR Tracking Code Other Other
Comments
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