Blue Moon Bell Retailer Application
If you'd like to be reviewed to become a retailer partner, please e-mail us at email@example.com, including the following information:
(1) Your First and Last Name
(2) Your E-mail Address
(3) Your Phone Number
(4) Store Name
(8) Zip/Postal Code
(9) Website URL (Please include "http://")
(10) Social Media Accounts (Please include links to all your social media accounts)
(11) Type of Retailer (Brick & Mortar; Online Only Retailer; Online & Physical Retailer)
(12) Speciality (Home & Garden Store, Etc.)
(13) How many years has your business been open?
(14) How many locations do you have?
(15) Reseller ID#
(16) Federal Tax ID#
(17) Name similar brands you carry (or will carry)
(18) How did you hear about us?
Please take a few minutes to provide this information in your e-mail. You will be notified once you are approved. If you have any questions regarding the status of your application, please contact firstname.lastname@example.org.