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Prospect

If you’re interested in opening a wholesale account with us or would like to receive further information about our product line, please complete the following questionnaire. Please expect a response within 1 business day.Required items are indicated in bold.
Company Name:
Bill-To Address Line 1:
Bill-To Address Line 2:
City:
State(2 Ltr)/Province:
Postal Code:
Country:
State Resale Certificate #:
Issuing State:
Years in Business:
Phone Number:
Fax Number:
E-mail:
First Name

Last Name:

Your Title:
Website:
Have you ever purchased from Teters Floral Products?: Yes
No
Anticipated Yearly Purchases of our Product Line: Under $1000$1000 – $10,000

$10,000 – $50,000

over $50,000

Requested Login: Id:
Password:

Shipping Location

Residential Address: Yes
No
Store Name(If different than above)
Ship-To Address Line 1:
Ship-To Address Line 2:
Ship-To City:
Ship-To State(2 Ltr)/Province:
Ship-To Postal Code:
Ship-To Country:
Ship-To Phone Number:
Ship-To Fax Number:
Ship-To E-mail:

Type of Business:
(check all that apply)
Arts & Crafts
Book
Department
Catalog
Educational
Farm
Florist
Furniture
Gift
Garden
Hardware
Museum
Nature
Pharmacy
Website
Other (Please enter below)
Where did you learnabout our products?
Are you interested in
a particular product or product line?
Quick Note: