Uncle Gene's Backwoods Products - Wholesale Info Request

Uncle Gene's Backwoods Products - Home of Uncle Gene's Backwoods Products

All I Ever Need Is You

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Wholesale Pricing Application Form
I am a: Wholesaler Distributor Broker Retailer
Area of Coverage (ie: 2 county or 5 state etc.)
Tell us a little about your Business
Who are your customers (Check all that apply) Deli's Grocery Stores Sporting Goods Stores Beverage Stores Gourmet/SpecialtyFood Markets Wineries Sports Arena Concessions Schools Golf Courses Restaurants and Bars Convenience Stores Vending Farm Markets Other
If Other: Please Explain
Your Company Name
Contact Name
Contact Title
Address Line 1
Address Line 2
City
State
Zip Code
Phone Number
Cell Phone (optional)
Email Address
Company Website
Federal Tax ID#
Years In Business Less than 1 1-3 4-10 More than 10 More than 20
Business Structure Corporation Partnership Limited Liability Corporation Other
If Other; Please List Type

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