Company Legal Name *

Store Name (If different from Co. Legal Name)

Primary Contact First Name *

Primary Contact Last Name *

Primary Contact Title *

Primary Contact Email *

Note: Responses will be sent to the email address provided above.

Contact Phone Number *

Store's Physical Address *

Will you carry Free Birdees products at this location? *

If No Above, Please explain.

How do you intend to sell Free Birdees products? (check all that apply) *

Number of Years Open *

Annual Revenue (Approximate) *

Size of Baby Department (% of store dedicated to baby merchandise?) *

Please list the top (3) three baby or kids brands you currently carry/sell. *

Store website

Store Instagram url

Store Facebook Page

Please Upload Tax Certificate *

Please Upload 2 Interior and 1 exterior images of your store.

Upload Interior Image 1 *

Upload Interior Image 2 *

Upload Exterior Image *

Please be sure to submit your application below. We will get back to you within 10 business days.

We will get in touch with you soon! Have a great day!

We will get in touch with you soon! Have a great day!

Currency

Baby (0-24m)