Wholesale Application Form

Thank you for your interest in becoming a LeeLeeRox retailer. Wholesale accounts approval is based on a variety of factors including but not limited to the following: method of operation, store location and territory availability, and store type and product mix. 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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