Ultra Paws Wholesale Account Application

Billing Address *

Shipping Address *

Primary Contact *

First Name Last Name
Position
Email *
example@example.com
Phone Number *

- Area Code Phone Number
Billing Contact

First Name Last Name
Position
Email
example@example.com
Phone Number

- Area Code Phone Number
Type of Business *

Dealer-Single Store Dealer-Multi-Store Dealer-Internet Only
Note: We are not looking for any resellers of our products on Amazon, Ebay, or any 3rd party marketplaces.
1. How did you learn about our company?
2. Why are you interested in Ultra Paws products?
3. How would you describe your typical customer?
By submitting this application, I certify I have read, understand, and will abide by Ultra Paws. Reseller Policy. I have the authority to apply on behalf of this business, and all the information in this application is true and correct.
Name *

First Name Last Name
Title and Company *
Date *

- Month - Day Year
Date
Should be Empty: