New Store Application

NEW STORE APPLICATION

Please complete the form below, and click submit. All fields are required.
You will be contacted by our staff once your application has been approved.

CUSTOMER INFORMATION
First Name:
Last Name:
Title:
Company Name:
Company Website :
Email Address :

BILLING ADDRESS
First Name
Last Name
Title
Address
City
State
Country
Zip/Postal Code
Phone

SHIPPING ADDRESS
First Name
Last Name
Title
Address
City
State
Country
Zip/Postal Code
Phone

CONTACT INFO
Phone
Fax
Email Address:

ACCOUNTING INFO
Name of Person in Charge of A/P
Phone
Fax
Email Address:

STORE INFORMATION
Store Trade Name
Store Legal Name
Website Address
How do you want to be listed on our website
Sales Tax or Resale Number
Federal Tax ID Number
Number of Stores
Number of Years in Business
Days & Hours of Operation
What is your primary type of business
What percentage of your business is jewelry
What is your best selling price point
Please list 4 Brands or Jewelry Designers that you currently carry in-stock
Brand 1
Brand 2
Brand 3
Brand 4
Please list 4 Trade Referneces
Trade Reference 1
Trade Reference 2
Trade Reference 3
Trade Reference 4
Where did you hear about us

Password
Confirm Password