Become a Bloom Retailer

Become a Retailer

Requirements:

We are not currently accepting online store applications. We are only accepting applications for brick and mortar store fronts.
Orders must currently reach at least $1,000 for the first order. These minimums are required to be met twice a year.

* Indicates required field

Person Filling Out Form *

First

Last

Person's Title *

Person's Email *

Store Name *

Main Store Address *

Line 1

Line 2

City

State

Zip Code

Country

Years in Business *

Number of Locations *

Target Customers *

Brands Carried *

Website *

Facebook URL *

Twitter URL *

Instagram URL *

Federal Tax EIN *

I agree to receiving marketing and promotional materials

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