Wholesale Account Information form
COOPER DESIGNS
GLASS-METAL
27 Owens Lane
Blue Hill, ME 04614
207-374-5940
rcooper@nlis.net
www.cooperbeads.com

WHOLESALE ACCOUNT INFORMATION


Business name________________________________________________

Contact person________________________________________________

Title________________________________________________________

Business address______________________________________________

______________________________________________

______________________________________________

Sales Tax number and state ______________________________________


Phone____________________ Email______________________________

Website__________________ Cell phone_______________________________

Type of business: Bead shop_______ Jewelry store__________

Craft shop or gallery___________ Jewelry designer___________

Other_____________

_____ Yes, I would like to receive periodic email updates about new products and classes.

_____ Please list my website as a LINK on your website under the following category: Bead Shops, Jewelry Designers, Suppliers, Galleries and Jewelry Stores (please circle one or more)

I am primarily interested in ___ Boro glass beads ___ Frit beads ___ Soft glass beads ___ PMC ___ Classes

THANK YOU

This Category is currently empty