nomadic state of mind
 
 

Please fill out the following Reseller Application to become an authorized reseller of Nomadic State of Mind products.

  

Business Name:

Street Address:

City, State, Zip Code

Legal Owner:

Bill To Address: (if different from above)

Street Address:

City, State, Zip Code

Telephone Number

Fax Number:

Email Address:

Website:

Type of Store

Federal Tax ID#

Reseller Permit #

Date Store Started?

List any other selling locations (if any)


Why do you want to sell our products at your location?

Copyright © 2001-2011 :: Nomadic State of Mind®

All Rights Reserved. Unauthorized reproduction of any material in part or whole is prohibited.

there are those who wander, those who follow and and those who ARE