First Name *

Last Name *

Email *

Phone Number *

What interests you in a wholesale account? *

Name of your store *

Briefly describe what products your store currently sells *

Do you currently have products that you plan on selling?

Can you briefly describe your craft? *

Can you briefly describe your practice? *

Please elaborate what interests you in a wholesale account *

Business Registration Number (Optional)

Annual Revenue *

Business Age *

Do you have a website / digital store (Etsy, Amazon, Facebook Marketplace, etc.)? *

Direct link to website / digital store *

Which social media are you active on? *

Facebook handle *

Instagram handle *

Tiktok handle *

What does your business do? Tell us about your business and how you will use our products. *

What's a business challenge that you would like us to help you solve? Include any additional questions/comments here. (Optional)

What products from our selection interest you? (Optional)

Are there products not currently in our selection that you'd like us to carry? (Optional)

How did you first hear about us? *

Please elaborate how you heard about us *

Thanks for getting in touch!

We appreciate you contacting us. One of our colleagues will get back in touch with you soon!

Have a great day!

Thanks for getting in touch!

We appreciate you contacting us. One of our colleagues will get back in touch with you soon!

Have a great day!

Jura - Super Automatic Espresso Machines

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