Wholesale Application Form

Thank you for your interest in becoming a LeeLeeRox retailer. Wholesale account approval is based on a variety of factors including, but not limited to, the following:

Once your account is approved, you will be able to log in to the website and view wholesale pricing and order online.

PLEASE NOTE: Opening orders for wholesale must be a minimum quantity of 24. All orders after that, or reorders, must be a minimum quantity of 12.

If you have questions, or require immediate assistance, please email loraewing@me.com

* Contact Person:

* Business Name:

* Street Address 1:

Street Address 2:

* City:

* Postcode:

* Country:

* State:


* Phone:


* Tax ID Number:

* E-Mail:

* Confirm E-mail:


* Enter the code in the box below:

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