WHSL - Waiting List

WHOLESALE MEMBER REGISTRATION

BELOW IS OUR REGISTRATION FORM FOR OUR
POTENTIAL WHOLESALE CUSTOMERS.

IF YOU WISH TO BECOME A WHOLESALE MEMBER,
PLEASE FILL OUT AND SUBMIT THIS FORM AND
YOU WILL BE CONTACTED VIA EMAIL AND/OR PHONE
WITH FURTHER INSTRUCTIONS. THANK YOU.
~ Mgmt. @ MAMDPB

     Business Name:

     Contact Person:

     Business Address:

     City:

      State:          Zip Code:

    Business Phone:

      Business Fax:

      E-Mail:

      Website URL:

      Type of Business:

       If Other, Please Explain:


       Would you like to be listed as a retail outlet for
       Me and My Dog Pet Bakery products?    YES   NO

Me and My Dog Pet Bakery ~ Jamison, PA 18929
Bakery Phone Number : (215) 343-7838