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Retailer Application

Thank you for your interest in offering Gardners Candies in your retail store. Please fill out the Retailer Application form below. All pending accounts go through an approval process and must be an approved account before placing orders.


*= Required Information Needed

Company Information *

 
Format: XXX-XXX-XXXX   

  
 

 
 
Tax ID will be required before account can be considered for approval.

Company Owner/Manager *

 
 
Format: XXX-XXX-XXXX  

   

Buyer Contact Information

Shipping / Delivery *

 

 
 

Billing Address (if different)




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