WHOLESALE ACCOUNT APPLICATION FORM

Dear New Customer,

Thank you for your interest in Fantasmagoria company's wholesale goods.

If you are a verifiable business with a registered company and would like to open a Wholesale account to make purchases, please fill in the following form.

Already have an account? Log in instead!

First name

Last name

Tel.

Password

Company name (as registered)

Shop name

Business Registration Number / EORI

Optional

EU VAT registration / Federal Tax ID Number

Business Registration Year

Country

Region/State

Optional

Postal Code/Zip

City

Address (line 1)

Address (line 2)

Optional

Website address(es)

Your company's Facebook page

Your company's Instagram page

Your sales channels (e.g. physical store, online at eBay)

What brands and products are you interested in, and what brings your interest in doing business with us?

For any questions, please call +37064866613 or email [email protected].