I. Business
CONTACT Information:
01. buyer/owner's full
Name:
[*]
02. business Name:
[*] If opening soon, enter
"new store"
03. type of store:
Please select
one...
Specialty shop/boutique
Small chain
[2-5 stores]
Medium chain
[6-12 stores]
Large chain
[13 or more]
New Store [Just
Opened]
New Store [Opening
Soon]
New Store
[Planning Phase]
Other
[*]
03. Street Address:
[*]
04. City/Town:
[*]
05. province/state:
Please
select one...
Alabama (AL)
Alaska (AK)
Alberta (AB)
American Samoa (AS)
Arizona (AZ)
Arkansas (AR)
British Columbia
(BC)
California (CA)
Colorado (CO)
Connecticut (CT)
Delaware (DE)
District Of
Columbia (DC)
Fed
Sts Of Micronesia (FM)
Florida (FL)
Georgia (GA)
Guam (GU)
Hawaii (HI)
Idaho (ID)
Illinois (IL)
Indiana (IN)
Iowa (IA)
Kansas (KS)
Kentucky (KY)
Louisiana (LA)
Maine (ME)
Manitoba (MB)
Marshall Islands
(MH)
Maryland (MD)
Massachusetts (MA)
Michigan (MI)
Minnesota (MN)
Mississippi (MS)
Missouri (MO)
Montana (MT)
Nebraska (NE)
Nevada (NV)
New Brunswick (NB)
New Hampshire (NH)
New Jersey (NJ)
New Mexico (NM)
New York (NY)
Newfoundland (NF)
North Carolina (NC)
North Dakota (ND)
Northern
Mariana Isles (MP)
Northwest Territory
(NT)
Nova Scotia (NS)
Nunavut Territory
(NU)
Ohio (OH)
Oklahoma (OK)
Ontario (ON)
Oregon (OR)
Palau (PW)
Pennsylvania (PA)
Prince Edward
Isle (PE)
Puerto Rico (PR)
Quebec (QC)
Rhode Island (RI)
Saskatchewan (SK)
South Carolina (SC)
South Dakota (SD)
Tennessee (TN)
Texas (TX)
Utah (UT)
Vermont (VT)
Virgin Islands (VI)
Virginia (VA)
Washington (WA)
West Virginia (WV)
Wisconsin (WI)
Wyoming (WY)
Yukon Territory (YT)
Other (Specify Above)
[*]
06. country/territory:
Please
select one...
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua / Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia / Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Terr
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Rep
Chad
Chile
China
Christmas Island
Cocos (Keeling) Isles
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia (Hrvatska)
Cuba
Cyprus
Czech Republic
Congo (DRC)
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Isles (Islas Malvinas)
Faroe Islands
Fiji Islands
Finland
France
French Guiana
French Polynesia
French Sthrn/Antarctic Lands
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
GuineaBissau
Guyana
Haiti
Heard Isle / McDonald Isles
Honduras
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau SAR
Macedonia (former Yugoslav)
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Isles
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
St. Kitts / Nevis
St. Lucia
St. Vincent / Grenadines
Samoa
San Marino
São Tomé / Príncipe
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia/S Sandwich I
Spain
Sri Lanka
St. Helena
St. Pierre / Miquelon
Sudan
Suriname
Svalbard / Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad / Tobago
Tunisia
Turkey
Turkmenistan
Turks / Caicos Isles
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
US Minor Outlying Isles
Uzbekistan
Vanuatu
Vatican City
Venezuela
Viet Nam
Virgin Islands (British)
Virgin Islands
Wallis and Futuna
Yemen
Yugoslavia
Zambia
Zimbabwe
[*]
07. Bus Telephone:
[*] please use the format
###-###-#### within canada/usa
08. buyer's email address:
[*]
If available, please
provide the following information:
09. Fax Number:
please use the format ###-###-####
within canada/usa
10. store web site address:
II. US CUSTOMS
INFORMATION:
11. US Tax ID Number
or EIN:
Required by US Customs when
shipping to the United States from Canada.
III. SUPPLIER/REP
TRADE REFERENCES:
Please list 3 suppliers/wholesalers
you currently purchase from or have purchased from in
the past. if you are opening a new store, list at least
1 supplier/rep you have already approached who can identify
your company.
[wholesale supplier 1]
12. company/supplier:
[*]
13. brand name/designer:
if the clothing line (designer/label)
is the same as the company name above, enter "same".
14. rep telephone:
[*] please use the format
###-###-#### within canada/usa
15. rep/contact name:
[*]
[wholesale supplier 2]
16. company/supplier:
17. brand name/designer:
if the clothing line (designer/label)
is the same as the company name above, enter "same".
18. rep telephone:
please use the format
###-###-#### within canada/usa
19. rep/contact name:
[wholesale supplier 3]
20. company/supplier:
21. brand name/designer:
if the clothing line (designer/label)
is the same as the company name above, enter "same".
22. rep telephone:
please use the format
###-###-#### within canada/usa
23. rep/contact name:
IV. OPTIONAL
ADDITIONAL INFORMATION:
24. How soon do you
plan on buying?
Please
select one...
Immediately
Next 30 Days
Next 60 Days
Next 90 Days
Next Season
Unknown or undecided
25. We currently have
two purchasing seasons each year - Fall/Winter and Spring/Summer.
Please let us know when you typically purchase for these
seasons so that we can meet your buying needs in the future.
Please choose the most typical answer:
Please
select one...
Typically
Apr/Oct
Typically
Apr/Nov
Typically
May/Nov
Typically
May/Dec
Typically
Jun/Dec
Typically
Jun/Jan
Typically
Jul/Jan
Typically
Jul/Feb
Typically
Aug/Feb
Typically
Aug/Mar
Typically
Sep/Mar
Typically
Sep/Apr
26. How did you find
our web site?
Please select one...
Search Engine
Mini Midi Maxi
A SoulDaisy Retailer
Soapbox Girls
Beautiful House Gallery Lounge
Magnetude Media
Word Of Mouth/Friend/Colleague
Other
27. If
you found us with a search engine or directory, please specify
which one:
Please select one...
AllTheWeb (FAST)
AOL Search
AltaVista
Ask Jeeves
Canada.com
CanadaSEEK.com
Compuserve
Dogpile
DMOZ
Excite
Fire Hunt
Google
Hotbot
listingsca.com
LookSmart
Lycos
MSN Search
Netscape Search
Open Directory
Overture
Retail Canada
ShopinCanada.com
ShopinVancouver.com
Teoma
Wholesale 411
World Wide Wholesale
Yahoo!
Other
Foreign
Language Search Engine
V. TERMS
OF APPROVAL:
souldaisy
clothing Designs reserves the right to verify the information
you provide. If you are not: a store owner, a buyer, a
buyer's assistant, or opening a new store - with the intention
of purchasing a minimum of $500 wholesale, or if you provide
false information or invalid trade references, your registration
will be denied. By submitting this application, you are
signing up to receive periodic follow-up emails and/or telephone calls from our sales department.
you may opt-out of future emails at any time by emailing
us.
I have read and accept the terms
and conditions and verify that the information I have
provided is accurate to the best of my knowledge. [*]