Wholesale Form

Thank you for your interest in Madelinetosh!

Please fill out the form below, and one of our representatives will be in touch with you regarding the possibility of opening a wholesale account. Please keep in mind that wholesale accounts are only available to stores that have (or are in process of opening) a brick and mortar storefront. We look forward to hearing from you!

Name

Name is required

STORE NAME

Company is required

Email is required

Phone Number

Phone Number is required

WEBSITE

STORE Address

Address is required

Tell us about your store?

How did you hear about Madelinetosh?

Are you planning to open a brick and mortar store with this new account?

Question/Comments

Thank you!

Lists*