Urban Aid: Retail/Wholesale Information Request

Wholesale Information Request

* required information

*Date:

*Business Name:

*Description:

*Store type: brick & mortar brick & mortar + website website only

*Number of locations:

Years in business:

If new, provide opening date:

*Contact name:

*Store location:
Street:

*City:

*State:

*Zip:

*Country:

*Tax ID (EIN/GST/VAT):

*State Sales Tax/Resale Number(s):

*Phone:

Fax:

*Email:

Web site:

How did you find out about Urban Aid products? Trade Show (please check one or more):

Intl. Gift Show: New York

Intl. Gift Show: Los Angeles

Intl. Gift Show: Atlanta

Pool Trade Show: Las Vegas

Received as gift

Magazine/Publication/Internet

Another retailer

Other

Comments, questions, or any additional information:

Filling out this form helps us to respond and direct all information requests in a timely manner. Our response rate is usually within 48 hours. If you have not heard from us please resubmit or call. Thank you for your interest in urban aid.