Patagonia Corporate Sales Application Form

Questions marked by * are required.
1.Company Name: *
2.Contact Name: *
3.Email Address: *
4.Company Address: *
5.City, State and Zip Code *
6.Company Phone Number: *
7.Please tell us about your company, and how you would like to use the Patagonia co-branded gear: *
8.Are you re-selling this gear, and to whom?: *
9.Do you have an on-line presence? -- URL: *
10.Do you have online retail access, either to your site or client stores (an online store)? -- If yes, please describe: *
11.Do you want to sell these garments directly to consumers - either through a website or a retail store?: *
12.Do you sell any un-decorated gear: *
13.Would you like order receipts to be emailed to you? If yes, to what email address: *
14.Do you have a resale certificate? Yes or No.