1. Customer Information

First Name *

Last Name *

Email *

Phone *

2. Store Address

Address Line 1 *

Address Line 2

City *

United States

State *

Zipcode *

Retail Store Name *

Website

Tax ID/ABN/VAT Number *

How Many Stores Do You Own/Manage

How Did You Hear About Us?

REQUIRED -- Lord Jameson is committed to maintaining our MAP and Distribution Policy which allows our authorized resellers (“Authorized Resellers”) to maintain high profit margins through the sale of Lord Jameson products (the“Products”). Lord Jameson has established this Lord Jameson Minimum Advertised Price (MAP) Policy and Confirmation Agreement Policy (the “Policy”) that an Authorized Reseller must follow for the advertising, marketing, and sales distribution of the Products. All Lord Jameson Authorized Resellers must agree to the terms and conditions of this Policy. I Agree To The MAP & Brick-N-Mortar Distribution Policy, Click Here to Review The Full Term *

I Agree To Have My Store Listed On The Online Store Locator *

REQUIRED -- Please add a copy of your Tax Exempt Certificate. *

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Thanks for your interest in a wholesale partnership!

We appreciate you submitting the form. One of our associate will get back in touch with you within one business day!

Have a great day!

Thanks for your interest in a wholesale partnership!

We appreciate you submitting the form. One of our associate will get back in touch with you within one business day!

Have a great day!