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Reseller Application Form
CREATE AN ACCOUNT FOR WHOLESALE PRICING ON OUR LAB GROWN DIAMOND INVENTORY!
1
2
3
Company Name
*
Company Address
*
Street Address
Address Line 2
City
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Armed Forces Americas
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State
ZIP Code
Phone
*
Ext.
Fax
*
Resale Certificate #
*
JBT #
Websites
*
Purchaser Name
*
Purchaser Email
*
Describe your business and list the products and brands that you carry
When ordering lab grown diamonds and/or jewelry on MEMO terms, I agree to send payment when the items are sold via the following
*
Select All
I will leave a credit card on file.
I will promptly send a check.
I will promptly send an ACH/Wire Transfer.
Number of locations
*
Please enter a number from
0
to
500
.
Does your location (s) Perform Watch Battery Replacement
*
YES
NO
If you answered YES, What brand of watch batteries do you purchase?
If you answered YES, Where do you purchase your watch batteries?
If you answered YES, Approximately how many watch batteries do you purchase a month?
Who do you purchase your jewelers equipment, tools and supplies from?
*
Thank you for your interest in doing business with us! A company representative will contact you soon and will request that you complete, sign and return our credit application. To get started, see below:
Download Credit Application: LINK Download Example of our MEMO Agreement: LINK
Owner Contact Information
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Last
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Accounts Payable Contact Information
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