Glass Boxes Handcrafted by Glass Artist Neal Hearn

Boxes By Neal

Wholesale Account Request

I accept wholesale orders from a business that is purchasing for the purpose of resale or corporate gifts. I do not allow multiple resellers in competitive close proximity to each other. If you will fill out the form below I will contact you with more information and pricing.

Please provide the following information about your business:

Business Name

Your Title

Your Name

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Phone

FAX

E-mail

Website

Do you have a storefront Yes No

Business Type Gift Shop Gallery Other

Your Sales Tax Number

Describe your Business or other reason for a wholesale account:

Home

Business Name
Your Title
Your Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Phone
FAX
E-mail
Website