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WHOLESALE REGISTRATION
Contact Name
*
First Name
Last Name
Company Name
*
Description of Business
*
Shipping Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email Address
*
Mobile
*
Country
(###)
###
####
Website
List the website(s) intended for the retail of Yogaru products
http://
Billing address (if different from above)
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
I, the undersigned, received and consent to the Terms & Conditions Contract supplied by Yogaru and wish to register as a Yogaru wholesaler
*
I understand and consent to all the Terms & Conditions supplied by Yogaru
*
Yes
No
Date
*
MM
DD
YYYY
Thank you!