Wholesale Price List Request Form

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Retailers interested in selling
Pleasant Valley Creative Crafts products...

...please fill out the following form. When you click "submit" the form will be sent to us by email. Your information will be kept confidential. It will not be shared in any way with other companies or individuals. Required fields are marked with an asterisk.
Contact Name*
Company*
E-mail*
Business License
or Sales Tax no.*
Address Line 1*
Address Line 2
City*
State*
Zip*
Phone*
Payment Method*
Net 30
†
Pre-pay
C.O.D.
†
If paying Net 30, please fill out at least 3 references
First Reference
Name
Company
Address Line 1
Address Line 2
City
State
Zip
Phone
Second Reference
Name
Company
Address Line 1
Address Line 2
City
State
Zip
Phone
Third Reference
Name
Company
Address Line 1
Address Line 2
City
State
Zip
Phone
Fourth Reference
Name
Company
Address Line 1
Address Line 2
City
State
Zip
Phone
   
Questions/Comments