* Name:

* Job Title:

* Store Name:

Doing Business As:

* Type Of Store: Choose A Store Type Storefront only eCommerce Website only Storefront and eCommerce Website

* Email:

* Confirm Email:

Your Website:

* Phone Number:

* Billing Address:

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* Shipping Address:

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* Physical Store Address:

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Number of Years in Business:

Enter your Resale Tax Number :

State Resale Number: By law, we cannot approve your account without receiving this number and a copy of your permit. After submitting your application, please email a copy of your permit to: orders@taylorelliottdesigns.com

* Tell us more about your store…What brands do you carry, bio, etc:

How did you hear about Taylor Elliott Designs: Choose One Instagram Facebook Through an Instagram/Facebook Ad Found products in a store In a showroom/At Market Through a Sales Rep Other

Instagram Handle:

Facebook Link:

As a reminder, please email a copy of your State Resale Permit to orders@taylorelliottdesigns.com. We cannot approve your wholesale application until we have a copy of this document on file.