Leila Cools Wholesale Form

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vacation

If you are a retailer and plan to buy in wholesale quantities:

Please fill in this form and press submit, or print and mail to :

Leila Cools ~ 229 Crawford St. ~ Toronto, ON ~ M6J 2V5 Canada

(Items in red are required)

Business Name
Street Address
Contact Name
City
Contact's Title
State/Province
Email
Country
Website Address
Zip/Postal
Phone
If other, please specify:
Fax

Type of Business
Years In Business

Retail Tax #

Products of Interest
Rings Bracelets Fused Glass Pendants
Fused Clay and Glass Pendants Cluster Bead Pendants
Other Please Specify

Comments/Suggestions

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This page last updated February 2007.