Wholesale Application

Section 1: Business Information Required

Legal Business Name *

DBA / Trade Name (if different)

Business Type *

Business Website

Business Phone Number *

General Business Email *

Section 2: Primary Contact Required

Full Name *

Title / Role

Direct Phone Number *

Direct Email Address *

This will be your login email.

Accounts Payable Contact (Optional)

Accounts Payable Email (Optional)

Section 3: Billing Information Required

Billing Address (Street) *

City *

State *

ZIP *

Country

Section 4: Delivery Information Required

Delivery address is the same as billing address

Receiving Hours *

Delivery Contact Person *

Delivery Phone

Special Delivery Instructions

I understand orders must be placed by Sunday at 11:59 PM for Thursday/Friday delivery. *

Section 5: Tax & Compliance Required

State Sales Tax ID Number *

Federal EIN (Recommended)

Upload Resale Certificate *

Accepted: PDF, JPG, PNG, DOC (Max 5MB)

I certify that the tax information provided is accurate and valid. *

Section 6: Payment & Credit Terms

All new wholesale accounts begin as Payment Due at Checkout.

Net 30 terms may be extended to approved accounts in good standing.

Preferred Payment Method

Estimated Monthly Order Volume (Optional)

Section 7: Business Type & Product Interest

Section 8: Agreement & Legal Acknowledgment Required

I agree to Mama Bird's Wholesale Terms & Conditions. *

I acknowledge and agree to the Net 30 Payment Policy (if credit is extended). *

I understand late fees may apply to unpaid invoices as outlined in the agreement. *

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