Wholesale Customer Registration

Please provide us your Shipping and Billing information below. This information will be used to process your order. Already registered? Click here to login.

Please note: To activate your wholesale account, you must place an opening order of at least $7,000.00.

Billing Information
Affiliate :
*
Resale Tax Id # :
*
Resale License #:
Please attach a copy of your original license here.
Company Name :
First Name :
*
Last Name :
*
Address Line 1 :
*
Address Line 2 :
City :
*
Country :
*

ZIP / Postal Code :
*
Phone Number :
*
Shipping Information
Please check this box if your shipping information is the same as billing. If it is not, you may simply add your shipping address in the future.
Store Information
Store trade name :
*
Legal name :
Where did you hear about us? :
What is your best selling price point :
*
What percentage of your business is jewelry? :
*
Days and hours of operations :
I do not have a website but will email pictures of my store (inside and out) to sales@laurengadams.com. I understand that my application will not be processed until after tile photos have been received. :
Website Address :
Number of Years in Business :
*
Complete physical address of each location if you intend to carry our line there :
*
Number of stores :
*
Federal tax id number :
*
Sales tax or resale number :
*
What trade shows do you attend? :
*
Primary type of business:
Fashion Clothing Store :
Fashion accessories/jewelry :
Gift store :
Art/gallery/craft gallery :
Fine Jewelry :
Please list four brands or jewelry designers you currently carry in-stock:
Brand 1 :
*
Brand 2 :
*
Brand 3 :
*
Brand 4 :
*
Accounting department Please provide details below of the person responsible for A/P:
Name :
*
Tel :
*
Fax :
*
Provide 4 trade references including contact information:
Trade reference 1 :
Trade reference 2 :
Trade reference 3 :
Trade reference 4 :
Account Information
Username (min - 4 chars) :
*
Password (min - 6 chars) :
*
Confirm Password :
*
Email Address :
*
Would you like to receive? :

E-mail format :
Other Information
How did you hear about us? :
*
Other :
Captcha

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Customer Service: 800-562-8860