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NEW STORE APPLICATION


Please complete the form below, and click submit.  All fields are required.
You will be contacted by our staff once your application has been approved.


CUSTOMER INFORMATION

First Name:
Last Name:
Title:
Company Name:
Company Website :
Email Address :
   

   
SHIPPING ADDRESS
First Name
Last Name
Title
Address
City
State
Country

Zip/Postal Code

Phone
   

CONTACT INFO

Phone
Fax
Email Address:
   

   

STORE INFORMATION

Sales Tax or Resale Number

Number of Stores

Number of Years in Business

What is your primary type of business

What percentage of your business is jewelry

What is your best selling price point

Please list 2 Brands or Jewelry Designers that you currently carry in-stock

Brand 1

Brand 2

Where did you hear about us

   

Password

Confirm Password

   

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