CHRISTINE by Van Thomas Concepts Vendor application:

1. Company name: *
2. Tax ID: *
3. Resale #: *
4. Contact: *
5. Address 1: *
6. Address 2:  
7. City: *
8. State: *
9. Zip Code: *
10. Email address: *
11. Phone: *
12. Preferred method of contact: *
    Email
    Phone
    
13. Website: *
14. Do you currently carry haircare products?: *
    Yes
    No
    
15. If yes, what brands:  
16. Est. Monthly retail sales: *
17. Type of sales: *
    Retail Location
    Website
    Salon
    Other
    

    (check all that apply)
18. Reload Image
    
19.  
    Please check the required fields

    

Your form has been sent. Thank you!