Please provide complete and accurate details about your business to help us evaluate your wholesale application.
Legal Business Name
Trade Name/DBA
Business Type
Corporation
Limited Liability Company (LLC)
Partnership
Sole Proprietorship
Cooperative
Non-Profit
Government Entity
Other:
Industry/Sector
Business Registration/Incorporation Number
Date of Incorporation/Registration
Business Website
Brief Description of Business Activities
Provide tax identifiers and registration information required for wholesale compliance.
Tax/VAT/GST Registration Number
Are you exempt from sales tax/VAT/GST?
Please upload your tax exemption certificate
Import/Export License Number (if applicable)
Product Categories You Are Licensed to Trade (if applicable)
Food & Beverages
Cosmetics
Pharmaceuticals
Chemicals
Electronics
Textiles
Children's Products
Industrial Equipment
Other
Details of the primary contact authorized to manage the wholesale account.
Full Name
Job Title/Position
Email Address
Direct Phone Number
Alternate Phone Number
Business Location Type
Headquarters
Regional Office
Warehouse
Retail Store
Manufacturing Site
Other
Business Address
Street Address
Street Address Line 2
City/Town
State/Province/Region
Postal/ZIP Code
Country
Is your shipping address the same as your business address?
Please provide full shipping address:
Help us understand your retail footprint and sales expectations.
Number of Physical Retail Locations
Do you operate an online store?
URL of your primary online store
Average Monthly Foot Traffic (all locations combined)
Average Monthly Online Visitors
Estimated Annual Revenue
Projected Annual Purchase Volume from Us
Select your preferred payment terms and provide credit references.
Requested Payment Terms
Net 15
Net 30
Net 45
Net 60
2/10 Net 30
Cash on Delivery (COD)
Prepayment Only
Primary Bank Name
Bank Contact Person
Bank Email/Phone
Trade Reference
Company Name | Contact Name | Phone | |||
|---|---|---|---|---|---|
A | B | C | D | ||
1 | |||||
2 | |||||
3 |
Requested Credit Limit
Tell us about your target market and product interests to receive tailored support.
Primary Target Market
Mass Market
Mid-Market
Premium/Luxury
Budget/Value
Niche/Specialty
Other
Product Categories of Interest
Electronics & Gadgets
Home & Kitchen
Fashion & Apparel
Beauty & Personal Care
Sports & Outdoors
Toys & Games
Books & Media
Food & Beverages
Health & Wellness
Office Supplies
Automotive
Industrial Tools
Preferred Price Range
Low (Under $10)
Mid ($10–$50)
Premium ($50–$200)
High-End ($200–$1000)
Luxury ($1000+)
Do you require private-label or white-label products?
Please describe your customization needs:
Build your first wholesale order below. Minimum opening order value is 500 USD (or equivalent).
Opening Order Line Items
Product SKU | Product Name | Color/Size/Variant | Quantity | Unit Price | Line Total | ||
|---|---|---|---|---|---|---|---|
A | B | C | D | E | F | ||
1 | SKU-001 | Bluetooth Speaker | Black | 50 | $20.00 | $1,000.00 | |
2 | SKU-002 | Wireless Charger | White | 30 | $15.00 | $450.00 | |
3 | $0.00 | ||||||
4 | $0.00 | ||||||
5 | $0.00 | ||||||
6 | $0.00 | ||||||
7 | $0.00 | ||||||
8 | $0.00 | ||||||
9 | $0.00 | ||||||
10 | $0.00 |
Sub-Total
Shipping Cost
Tax/VAT/GST
Grand Total
Preferred Shipping Method
Standard Ground
Express
Overnight
Freight (LTL/FTL)
Customer Pickup
Requested Delivery Date
Special Packing/Shipping Instructions
Would you like to receive promotional materials?
Preferred format
Email Newsletters
Printed Catalogs
SMS Alerts
Social Media
How did you hear about us?
Trade Show
Online Search
Referral
Social Media
Advertisement
Other:
Who referred you?
Are you interested in co-op marketing funds?
Review and accept our wholesale policies to finalize your application.
I confirm that all information provided is accurate and complete.
I agree to the Wholesale Terms & Conditions
I consent to credit checks and verification of references
Do you agree to receive transactional emails?
Authorized Signature
Analysis for Wholesale Account Application & Opening Order Form
Important Note: This analysis provides strategic insights to help you get the most from your form's submission data for powerful follow-up actions and better outcomes. Please remove this content before publishing the form to the public.
This wholesale-account application is unusually thorough, combining partner vetting with first-order capture in one flow. By demanding legal identifiers, tax numbers, credit references, and a minimum-opening order, the supplier receives a complete risk profile before shipping anything, which sharply reduces bad-debt exposure and ensures only serious, credit-worthy retailers are onboarded. The logical sectioning—from business identity, tax, and compliance through credit, product interest, and order specifics—mirrors the internal underwriting checklist most finance teams follow, so data can flow straight into ERP or CRM without re-keying.
Strengths include: (1) Mandatory data points align with KYC, AML, and credit-check requirements; (2) Smart conditional logic (e.g., "Other business type" or tax-exempt certificate upload) keeps the perceived length down; (3) Currency, numeric, and date fields reduce formatting errors; (4) Table-based order grid with formulaic line-total calculation gives immediate visual feedback, encouraging larger baskets; (5) Marketing-opt-in and co-op funds questions turn the form into a lead-gen and channel-marketing tool as well. The main weakness is length: 60-plus fields can deter micro-retailers, so a save-and-continue or progressive-disclosure mechanism would raise completion rates.
Purpose: Establishes the exact legal entity that will sign the wholesale agreement and be liable for payment. It is the anchor for all downstream compliance, credit, and invoicing records.
Effective Design: Single-line open text, mandatory, placed first in the Business Information section—classic prominence. No character limit allows for long global entity names, while placeholder text is absent to avoid暗示 formatting.
Data Quality: Because the field is free-text, validation against secretary-of-state or company-registry APIs is recommended post-submission to catch typos or shell companies. Pairing with the registration number field provides a composite key for verification.
Privacy: Publicly discoverable information; no special privacy risks.
UX: Straightforward and universally understood; zero cognitive load.
Purpose: Determines credit-risk class and which tax forms (W-9 vs. W-8BEN-E, etc.) must be collected. Corporations and LLCs generally receive higher credit limits than sole proprietors.
Design Strength: Single-choice radio with clear, legally recognised options plus an "Other" path avoids ambiguity. Follow-up text box appears only when needed, keeping the UI clean.
Data Collection: Categorical data is easy to segment for portfolio reporting and automated credit-policy rules.
UX: Quick selection; no typing required for 90% of users.
Recommendation: Consider icons or colour coding to speed visual parsing, but current implementation is already effective.
Purpose: Mandatory for invoice compliance and reclaim of input VAT; also cross-checked against government databases to confirm legitimate trading status.
Design: Free-text field accepts any global format, preventing front-end regex errors that could block valid applicants.
Data Quality: Supplier can batch-validate via VIES or similar services. Storing the number is a legal obligation, so encryption at rest is advised.
Privacy: Semi-sensitive; access should be role-restricted to finance teams.
UX: One field versus separate country-specific boxes reduces friction for multinational applicants.
Purpose: Identifies the natural person legally empowered to bind the retailer to payment terms and handle disputes.
Design: Mandatory single-line text early in the contact section, signalling importance. No dropdown title (Mr/Ms) keeps speed-to-completion high.
Data Collection: Combined with email and phone, it builds a communication record that can be ported to CRM for lifecycle marketing.
UX: Universally understood; no improvement needed.
Purpose: Directly drives cash-flow forecasting and Days-Sales-Outstanding metrics. Net 60 requests require deeper credit scrutiny than Net 15.
Design: Single-choice radio list includes common B2B terms plus 2/10 Net 30, educating applicants about early-pay discounts. Mandatory status forces explicit choice, eliminating the default-bias problem.
Data Quality: Captures the applicant’s working-capital expectations up-front, enabling automatic pricing and credit-limit algorithms.
UX: Clear, concise, and jargon-free.
Purpose: Feeds demand-planning and personalised catalogues; also flags any restricted categories (e.g., pharmaceuticals) that need licence verification.
Design: Multiple-choice checkbox with 12 common verticals plus free-text path. Mandatory status guarantees at least one category, ensuring sales teams have a starting segment for follow-up.
Data Collection: Creates rich behavioural data for RFM scoring and targeted promotions.
UX: Checkboxes are faster than dropdown multi-select, and the list fits without scrolling on mobile.
Purpose: Together they validate the 500 USD minimum and allow production-planning and logistics to promise an achievable ship date.
Design: Table with auto-calculated totals reduces arithmetic errors; date-picker enforces lead-time rules (e.g., cannot choose tomorrow if lead time is 5 days).
Data Quality: Numerical consistency checks (subtotal + shipping + tax = grand total) can be run before submission, preventing order-entry headaches.
UX: Real-time feedback keeps users confident about hitting the minimum; calendar constraints avoid over-promising.
Purpose: Creates a legally enforceable trail that the applicant acknowledged terms and consented to credit checks.
Design: Mandatory checkbox for accuracy and for Ts&Cs; electronic signature and dated. Together these satisfy UETA and eIDAS requirements for electronic contracting.
Data Collection: Timestamps and IP capture (recommended back-end addition) strengthen evidentiary value.
UX: Placing these at the very end capitalises on the foot-in-the-door effect: users who have already invested in filling 50+ fields are unlikely to abandon at the last mile.
Mandatory Question Analysis for Wholesale Account Application & Opening Order Form
Important Note: This analysis provides strategic insights to help you get the most from your form's submission data for powerful follow-up actions and better outcomes. Please remove this content before publishing the form to the public.
Legal Business Name
Justification: This is the single most important identifier on the contract, invoices, and credit agreements. Without the exact legal entity name, the supplier cannot perform lien searches, UCC filings, or enforce payment in court, exposing the company to unrecoverable debt.
Business Type
Justification: Risk profiles differ dramatically between corporations and sole proprietors. This field drives automatic credit-policy rules, determines personal-guarantee requirements, and ensures the correct tax forms are generated, making it indispensable for underwriting.
Industry/Sector
Justification: Certain industries carry higher return rates or regulatory restrictions (e.g., children’s products). Capturing this up-front allows the supplier to apply sector-specific credit limits and compliance checks, avoiding costly order blocks later.
Business Registration/Incorporation Number
Justification: Acts as the unique key to verify legal existence with government registries, preventing fraudulent shell companies from entering the portfolio and ensuring KYC compliance.
Date of Incorporation/Registration
Justification: Younger entities present higher credit risk. This date feeds into scoring models that automatically adjust payment terms and credit limits, making it essential for prudent exposure management.
Tax/VAT/GST Registration Number
Justification: Mandatory for tax invoicing and reclaim procedures; also serves as a cross-border validation point for international retailers, ensuring compliance with global trade regulations.
Full Name (Principal Contact)
Justification: Establishes a natural person legally authorised to bind the retailer, required for enforcement of personal guarantees and for serving legal notices if the account defaults.
Job Title/Position
Justification: Confirms authority level (e.g., Owner vs. Purchasing Clerk). Credit teams use this to assess signing capacity and to route future communications to the correct decision-maker.
Email Address
Justification: Primary channel for order confirmations, shipping notices, and dunning letters. Without a verified email, the supplier cannot automate critical lifecycle communications, leading to payment delays and increased service costs.
Direct Phone Number
Justification: Required for urgent exception handling (stock-outs, payment failures) and for two-factor authentication when accessing the B2B portal, ensuring continuity of service.
Business Location Type
Justification: Determines whether goods ship to a retail store, warehouse, or manufacturing site, affecting freight class and routing rules. Incorrect classification can trigger costly re-consignments.
Complete Business Address Fields (Street, City, State, Postal, Country)
Justification: Needed for credit-report matching, tax jurisdiction determination, and logistics optimisation. Missing postal codes can invalidate shipping-rate calculations and delay dispatch.
Number of Physical Retail Locations
Justification: A key predictor of purchase volume and brand exposure. This metric feeds directly into tier-pricing decisions and market-development fund allocations.
Estimated Annual Revenue
Justification: Primary input for debt-service-coverage calculations. Without revenue data, credit teams cannot set responsible credit limits, exposing the supplier to over-trading risk.
Projected Annual Purchase Volume from Us
Justification: Aligns sales forecasting with production planning and consignment-stock decisions, ensuring the supplier can commit to service levels without over-stocking.
Requested Payment Terms
Justification: Directly impacts cash-flow modelling and bad-debt provisioning. Capturing this as mandatory prevents silent defaults to costly Net 60 terms that erode working capital.
Primary Bank Name
Justification: First reference point for cash-flow verification calls. Banks confirm average balances, giving an independent view of liquidity before credit is extended.
Trade Reference 1 & 2
Justification: Industry-specific suppliers can attest to payment behaviour better than generic credit bureaus. Two references provide redundancy; if one is unresponsive, the second still validates history.
Requested Credit Limit
Justification: Sets the ceiling for exposure management and insurance coverage. Without an explicit request, the supplier cannot reconcile internal limits with insurer caps, risking uninsured losses.
Primary Target Market
Justification> Guides product-mix recommendations and pricing strategy. A luxury retailer receives exclusive SKUs, whereas a value channel gets volume packs, ensuring brand positioning consistency.
Product Categories of Interest
Justification: Ensures the retailer is licensed to resell selected categories (e.g., cosmetics require FDA registration) and prevents shipment of restricted goods that could incur penalties.
Preferred Price Range
Justification: Aligns catalogue recommendations and volume discounts, reducing quote turnaround time and increasing the probability of basket conversion.
Preferred Shipping Method & Requested Delivery Date
Justification> Both fields drive logistics cost and promise accuracy. Mandatory capture prevents orders with ambiguous lead times that result in expedited-shipping surcharges and customer dissatisfaction.
Accuracy & Ts&Cs Checkboxes, Signature, Application Date
Justification: Creates a binding electronic contract and satisfies audit requirements for SOX and ISO-9001 traceability, protecting the supplier in disputes.
The current strategy rightly front-loads risk-critical data, but the high mandatory count (≈30) can suppress conversion among smaller retailers. Consider progressive revelation: keep legal, contact, and opening-order value mandatory in phase 1 to generate a lead; move credit references and detailed financials to phase 2 after initial approval. Use conditional mandatories—e.g., only require import/export licence if the selected country is outside the free-trade zone. Finally, add inline helper text explaining why each field is needed (e.g., "We use your tax number to issue VAT-compliant invoices") to build trust and reduce perceived burden.
To balance data richness with completion rates, implement a dynamic progress bar that segments the form into «Business Identity», «Credit Profile», «First Order», and «Agreements». Users can save and resume, decreasing abandonment. Periodically audit mandatory fields against actual usage: if a field is not referenced in any credit decision or report within six months, downgrade it to optional. This keeps the form lean while preserving the comprehensive risk assessment that makes the wholesale application effective.
To configure an element, select it on the form.