Business Contact Information

Company Name *

VAT/TIN Number *

Phone Number: *

Email Address *

Registered Company Address: *

City *

State *

Zip Code *

Primary Shipping Address: *

City *

State *

Zip Code *

Secondary Shipping Address (optional)

City

State

Zip Code

Preferred Payment Method *

AP Contact

Name

Phone

Additional Business Information

Type of Business *

**Disclaimer: We are not currently looking to partner with online-only businesses at this time. They will only be approved under special circumstances.

CEO/Owner's Name *

Website Homepage URL *

Dedicated Retail Space (Sq. Ft) *

Years in Business

Upload 2-3 clear images of your storefront. *

Business/Trade References

Reference 1: *

Company/ Reference Name *

Phone Number *

Email Address *

Address *

City *

State *

Zip Code *

Type of Account

Reference 2: *

Company/ Reference Name *

Phone Number *

Email Address *

Address *

City *

State *

Zip Code *

Type of Account

Reference 3:

Company/ Reference Name

Phone Number

Email Address

Address

City

State

Zip Code

Type of Account

Bank Name *

Primary Banking Contact Name: *

Phone/Fax Number *

Account Number *

Type of Account *

Bank Address *

State *

City *

Zip Code *

Requested Credit Limit *

Primary Business Address *

State *

City *

Zip Code *

How long have you been at this curent address? *

Thank you for applying to become a dealer. A sales manager is currently reviewing your application and you should receive an update on your application status within 2 business days. Please reach out to sales_support@ g-form.com with any questions.

Have a great day!

-G-Form Team

Thank you for applying to become a dealer. A sales manager is currently reviewing your application and you should receive an update on your application status within 2 business days. Please reach out to sales_support@ g-form.com with any questions.

Have a great day!

-G-Form Team

Become a G-Form Wholesale Partner

Please fill out this application and a representative from our team will reach out shortly!

Business Contact Information

AP Contact

Additional Business Information

Business/Trade References

Reference 1: *

Reference 2: *

Reference 3:

Thank you for applying to become a dealer. A sales manager is currently reviewing your application and you should receive an update on your application status within 2 business days. Please reach out to sales_support@ g-form.com with any questions.

Thank you for applying to become a dealer. A sales manager is currently reviewing your application and you should receive an update on your application status within 2 business days. Please reach out to sales_support@ g-form.com with any questions.

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