Wholesale -> Distributor Registration

Distributor Registration

If you are interested in becoming a distributor for the Je T'aime Fragrances line of premium quality products, please complete the following form. You will be contacted following verification of the information provided, usually within 48 hours.

NOTE:
To be eligible for Distributor pricing you must provide a valid Tax ID Number for your business.

INTERNATIONAL REGISTRANTS:
Please select "Not Applicable" for the "State" and "State of Issue" fields. If your country does not require you to have a Tax ID number, please enter "Not Required" in the "Sales Tax ID Number" field.

ATTENTION: Nigeria and USA embargoed countries - DO NOT APPLY!

- If you have questions or require assistance, our Live Support
representatives will be happy to assist you in any way they can.

NOTE: YOU MUST ENTER THE VERIFICATION CODE TO SUBMIT THIS FORM.
If you are unable to read the code, you may click the
purple refresh button to find one that is readable.

* - indicates a required field

Distributor Registration

Company Name	*
Address Line 1	*
Address Line 2
City	*
County
State	*
Province/Region
Country	*
Postal Code	*
Contact Name	*
E-Mail Address	*
Phone Number	*
Fax Number
Website Address
Sales Tax ID Number	*
State Of Issue	*
Territory Desired
Company Type	*
Sales Manager
# of Sale Reps
Do you participate in Trade Shows	*
Which ones/What market
Comments

Notice: Your privacy is important to us. In accordance with our Privacy Policy, the information collected on this form is for internal use by Je T'aime Fragrances only and will not be sold or distributed to anyone.

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Last Updated: March 28, 2009