Complete the Wholesale Application Below to Unlock Pricing

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Let us do this part

Today's Date:

Fri Mar 13 2026 10:17

Practitioner:*

Business Name:*

Owner’s Full Name:*

Email Address:*

Phone Number:*

Business Address (including city, state, and zip):*

Website or Social Media Page:*

Please read and answer

Type of Business*

Tattoo Studio, Piercing Shop, Tattoo Supply Company, Online Retailer, Other

Years in Business*

Number of Artists or Shops Served (if distributor)*

Do you currently carry tattoo aftercare or numbing products?*

Wholesale Intentions*

Estimated Monthly Order Volume *

Do you plan to sell online, in-store, or both?*

If any provision, section, subsection, clause or phrase of this release is found to be unenforceable or invalid, that portion shall be severed from this contract. The remainder of this contract will then be construed as though the unenforceable portion had never been contained in this document.

Client Information

I hereby declare that I am of legal age (with valid proof of age) and am competent to sign this Agreement.

Name:*

Address:*

Postcode:*

Date of birth:*

You must be 18 or older

Age:

Phone #:*

Email:*

Social Handle:

If you don't mind us tagging you in photos online

Signature:*

Sign or type signature: