EXCLUSIVE 5% off your first purchase! Use Coupon Code GO2017
 
 

Laguna Wholesale Account Request Form

 

To receive a Laguna Wholesale account, please complete all information requested below. Your information will be reviewed prior to your account being set up & activated.

All information is kept confidential and will not be shared, or distributed with any other company or individual.

Your Company Name*
Your Full Name*
Type of Business* Retail
Online
Boutique
Other
If Other
Reseller #(California Only)
Your Title*
Your E-mail*
Your Phone*
Company URL (if any):
Business Address
City
Zip Code
States
Country
Brief Description of Store / Business*

 

 
 
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