Medicine Mama's Wholesale Application Please fill out the questions below Question Title * 1. Please provide us with some basic information about your store Store name: Store street address: Store City, State, & Zip Code: Store website: Buyer Name: Buyer Phone Number: Buyer Email: Question Title * 2. What do you primarily sell at your store? Organic / natural foods and supplements Natural remedies or pharmaceuticals Beauty supplies, skincare, or cosmetics Other (please specify) Question Title * 3. Do you sell products online? No, I do not sell any products online Yes, my sales are all online I sell both in a brick-and-mortar store and online Question Title * 4. Why are you interested in carrying our line of organic healing skin creams? Question Title * 5. What products are you most interested in retailing? Sweet Bee Magic Sweet Bee Magic Wand Vmagic Vmagic Wash Question Title * 6. How did you hear about us? Question Title * 7. Please enter your resale certificate number: Done