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OPV RETAILER FORM
OPV Retail Partner Application Form
Name
*
First
Last
Email
*
Company Name
*
Length of Time in Operation
*
Country of Residence
*
Business Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
Country of Sales
*
Sales Channels - Select All That Apply
*
Website
Physical Store
Online Marketplace (i.e. Amazon, Ebay, Taoboa)
Distribution
Other
Please provide website URL for each web-based sales channel. (e-commerce site)
*
Number of Physical Stores
*
Physical Store Address - Fill Out Only If Applicable
*
Line 1
Line 2
City
State
Zip Code
Country
Promotional Social Networking Websites
*
Facebook
Twitter
Instagram
Others
Please provide the profile names and web addresses for all social networking websites.
*
Who is your clientele?
*
Budget/Start Time?
*
What type of products and brands do you carry?
*
Why are you interested in becoming a OPV retailer
*
If applicable, please include interior and exterior photographs of your physical store. (store name must be clearly visible)
Attach a File
*
Max file size: 20MB
Attach a File
*
Max file size: 20MB
Attach a File
*
Max file size: 20MB
Submit
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