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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. What is the approximate quantity of your order?: *
8. Please tell us about your company, and how you would like to use the Patagonia co-branded gear: *
9. Are you re-selling this gear, and to whom?: *
10. Do you have an on-line presence? -- URL: *
11. Do you have online retail access, either to your site or client stores (an online store)? -- If yes, please describe: *
12. Do you want to sell these garments directly to consumers - either through a website or a retail store?: *
13. Do you sell any un-decorated gear: *
14. Would you like order receipts to be emailed to you? If yes, to what email address: *
15. Do you have a resale certificate? Yes or No.