PACIFIC FLORAL EXCHANGE INC

WHOLESALE ACCOUNT APPLICATION

Thank you for your interest in becoming a wholesale customer. Please complete the form below. We'll review your application within 1-2 business days.

BUSINESS NAME

BUSINESS LICENSE/ TAX ID #

YEARS IN BUSINESS

CONTACT INFO

CONTACT NAME

PHONE NUMBER

EMAIL ADDRESS

PREFERRED METHOD OF CONTACT

EMAIL

PHONE

TEXT

BILLING INFO

BILLING ADDRESS

SHIPPING ADDRESS

Address where you will be shipping orders to.

(Type SAME if same as billing address)

BILLING EMAIL ADDRESS(ES)

Email where you would like to have your invoices sent to.

ORDER PREFERENCES

ESTIMATED MONTHLY PURCHASE VOLUME (WHOLESALE HAS A MINIMUM $100 PER ORDER)

Please note that if no orders are placed within a 6-month period, your wholesale account may be deactivated.

PREFERRED PAYMENT METHOD

Credit Card

ACH/Bank Transfer

OTHER

All accounts are "Due upon receipt". Request for Net 10/15/30 payment terms are subject to additional review and approval.