Retailer Interest Form

Please fill out the form below if you are interested in becoming a Storywheels retailer.
Please understand that you must buy into the Storywheels program.

You MUST include your TAX ID / Resale Number information otherwise we will not respond.

We look forward to contacting you and for you joining the Storywheels retailer family!

Company Name: *

Corporate Name: *

JBT Number:

Resale Number: *

Resale State:

Address: *

City: *

State: * - Select -NoneAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon TerritoryAustralian Capital TerritoryNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia

Zip: *

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Contact First Name: *

Contact Last Name: *

Phone: *

Email Address:

Fax:

Bank Name: *

Bank Account: *

Bank Contact: *

Authorization: *

Yes, I hereby authorize Color Craft and/or its agents to review this application and process the information as needed. I affirm that I have the authority to submit this information.

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