TIEM Wholesale Account Request
Fill out the information below and we'll send you an invite to our online wholesale portal once approved!
Sign in to Google to save your progress. Learn more
Business name *
Primary contact name *
Primary contact email *
We can add more emails to your account after it's created, upon request.
Primary contact phone *
Business Address *
You will have the opportunity to enter a different shipping address after your account is approved. Please enter your main business/billing address here.
Business Website *
Business Social Media Handles (optional)
Tell us a bit more
Providing a little more info about your business will help us respond to your request more quickly
How would you describe your business?
Check all that apply
How are you looking to partner with TIEM?
Check all that apply
Anything else you'd like to share?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of TIEM. Report Abuse