Bead Bazaar

Create New Wholesale Account

Please complete the information below to create a new wholesale account. Remember to save your account password as you will need it to review any online orders you place.

Required fields are marked with a star (*). Click the 'Submit' button at the bottom of this form to proceed.

Login Information

Email Address*

Email Address (Confirm Entry)*

Username*

Username (Confirm Entry)*

Password*

Password (Confirm Entry)*

Contact Information

First Name*

Last Name*

Company Name

Telephone Number*

Fax Number

Address

Address: Line 1*

Address: Line 2

City*

State/Province*

Country*

Zip/Postal Code*

Residential/Commercial*

Email Subscriptions

Available Email Subscriptions

General email subscription list

Internet site news and updates

Product news and updates

Additional Information

Resale Number/Tax ID/Not Applicable*

Type of Store*

Website Address

Image Verification

Image Verification*

Image Verification

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