♪Name of Company: 
♪Contact Name: 
♪Address:  
♪City:  ,   ♪State:    ♪Zip: 
♪Country: 
♪Phone:          Fax: 
Alternate Phone (or Cell): 
Alternate Contact Name: 
♪Contact Email Address: 
Uncheck this Box if you do NOT wish the above email address to be added to our Wholesale Pagan Music Newsletter.

♪Your State Resale Tax ID#: 
<And/Or>   Federal EIN#: 
(If we are unable to verify your business through Dun & Bradstreet, it will be necessary to have your actual State Resale Tax ID Certificate Faxed to 407-366-5034 to lower your minimum order from $200 to only $50.  Note: If your Business is registered in Florida, it is mandatory that you fax a copy of your Florida State Resale Tax ID Certificate to us before your account can be approved.  Please fax it now.)

Store's Website URL: 

Check this box if you have a Physical Store with Walk-In Customers.

♪Preferred Payment Method:  PayPal Visa Mastercard Discover American Express Business Check Money Order COD

Check this box if you want your 1st order sent COD.  There will be a COD Charge added to your order's total.  Note:  When ordering online you can submit a credit card securely or pay with PayPal, or choose to send in a Check or Money Order.  If you order via phone or fax, you can submit your credit card information at that time as well.

The following boxes MUST be checked.  Please read them and check the box stating you understand.

♪  I understand that there's a $50 Minimum Order if it is possible to verify my company through Dun & Bradstreet's database.  If not, my minimum order will be $200, unless I fax an actual copy of my State Resale Tax ID to 407-366-5034. (All International Wholesale Customers will be set at a $200 min. order.)
♪  I understand that I may receive 1 DEMO of any CD at 50% discount, (as long as I purchase 3 of the same CD at regular wholesale price), by submitting a follow up email sent to earthtones@paganmusic.com and referencing my order number after placing my online order, or by mentioning it in the Fax or Phone Order when I place it. 
1 Demo of each CD per client only.