Tallulah Moon Wholesale Application

Name of Company

Contact Name

Address

City/State

Zip Code

Resale Number

Tax ID

Phone

Fax

Website

Email

Type of Store

Online
Storefront
Both

Please describe other products and brands you carry in your Store.

How did you hear about Tallulah
Moon?

NOTE: We do NOT do drop shipping or International shipping at this time.

To view our Wholesale Policy please click here