Wholesale

If you are interested in wholesales opportunities, please contact us by filling in the form below. Our sales representatives will get back to you shortly

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Wholesale

What is your business name that should appear on invoices? *

Business Number *

Company Website or Social Media profile (URL)

Primary Contact First Name *

Primary Contact Last Name *

Primary Contact Email *

Primary Contact Phone Number *

Primary Contact Role *

Is the Accounts Payable contact different from the Primary Contact?

Accounts Payable contact First Name

Accounts Payable contact Last Name

Accounts Payable contact email

Accounts Payable contact phone number

Please detail how you plan on using or selling Bio Life products *

Billing / Shipping

What is your billing address? *

Is your shipping address the same

What is your shipping address?

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Wholesale

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