Wholesale Application Form

Thank you for your interest in Samovar’s Wholesale Program. To apply, please fill out the below form (all fields are required).

Contact Information

Your Name:

Your Email:

Your Phone:

Business Information

Company Name:

Company Website:

Annual Revenue:

Owner, partner, or corporate executive:

Resell Certificate Number (if applicable):

If no Resell Cert, then Business License Number:

Type of Business: Other:

What types of products are you interested in?  Bulk tea Tea Boxes Tea Ware

Account Setup Information

Do you have an existing Samovar account you would like to use? If not, click here to set one up and then select Yes below. Or select No and we will set up a new account using the information you provide below.

If yes, what is the email associated with the account?

If no, please provide the following account information:

Contact Name:

Contact Email:

Contact Phone:

Billing Address:

 Add me to Samovar's Wholesale Program mailing list for occasional product updates and exclusive promotions.

Terms

I agree to Samovar Tea Lounge’s Terms of Sale.

Additional comments?

A Little Math to Prove You're Human:
99+1=? 

AUTHORIZATION: The undersigned is giving Samovar Tea Lounge, California authorization to contact your credit references. Also, the undersigned will authorize Samovar Tea Lounge to charge the credit card listed above on their first two (2) orders. Accounts past due over 14 days will be automatically charged on the listed credit card above.