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Dealer Inquiry Form:
Thank you for your interest in purchasing Memory Maker products for resale. Please complete the following form in it's entirety so that we may qualify your wholesale account.

Memory Maker®
A division of Key Item Sales, Inc.

Date:
How did you hear about us?
Business Name:
DBA if any:
Street Address:
City, State, Zip:
Telephone/Fax:

Contact Name:
Resale #
Title:
Tax ID or SSN#
Email Address:
*Please note that businesses located in California or New York are required to complete and return a valid resale certificate. Fax to (818) 885-6319
Website:

 
Year Business was Established?
Type of Business?
Sole Proprietorship
Partnership
Limited Liability Company
Private Corporation
Nonprofit Corporation
Nature of Business?
Avg. Annual Sales?
Do you have a storefront?
How would you like to receive further information?
Mail
E-mail
Fax
Phone
 
*Please note this is not a credit application, please do not submit additional trade references.
 

Memory Maker® Photo Bracelet
Patent Pending Under License of Q.J.D.M.

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