Store Name:   dba:
List any other company names associated with your retail store:
Store Phone Number:   Alternate Phone Number:      
Store Address:   City:   State:   Zip:  
Billing Address (if different): City: State: Zip:  
Warehouse Address: City: State: Zip:  
Owner(s) Name (first & last name):   Buyer(s)/Manager(s) (authorized on account):
Have you ever purchased the Elf on the Shelf for resale?   If Yes, from whom (seller & contact):
Email Addresses (enter separate email addresses, as needed.  If all emails should go to the same contact, then just fill in the "Buyer Email")
     Buyer/Owner Email:    (receives order confirmations) 
     Accounts Payable Email:     (receives invoices)
     Warehouse Email:     (receives shipment confirmations)
Store Website URL:
Does your store have a page on Facebook or Instagram? If Yes, under what name can we find your accounts?
Facebook: Instagram:
Is there any other social media profiles for your store? If yes, please list each profile:
What websites are currently selling your product?:
Do you Plan on selling the Elf on the Shelf on any additional websites? If yes, please list each website: (please list any additional names you may use on each site)
How many store locations?  (if multiple, please lest them below)
      Additional store locations & addresses:
To best serve you, please fill out the below information.  Please note all parcel orders will be billed on each invoice and shipped via our FedEx ground account.  Orders that reach the minimum weigh requirements may go via your Freight account.
Lift gate required?:   Mall location?:   Do you prefer all orders to ship parcel? (i.e. the store cannot accept freight or it is a burden to the store/employee)
Freight shipping account information (company, account number & address): (only used if order meets minimum freight requirements)
Do you distribute outside of the US (if yes, where?):
Federal Tax ID (you will be asked to provide a copy):   State Tax ID (you will be asked to provide a copy):  
ST-5 ( state of GA only.  You will be asked to provide a copy):        
For tax purposes, what category is your store registered with your state (i.e. gift, toy, book store)?  
Buying Group affiliation (name & account number):   (if applicable)
        March 7, 2014 v.2