Wicks & Wax Wholesale Price Application

Registered Name_____________________________________________________________

Legal Name________________________________ Owner's Name_____________________

Operating Name______________________________________________________________

Street Address_______________________________________________________________

City__________________ Province/State_________________ Postal/Zip Code____________

Telephone (___)____________________ Fax (___)_________________________________

Nature of Business_____________________________________________________________

PROVINCIAL SALES TAX # (PST - within B.C. only)___________________________

BUSINESS LICENCE # (outside of B.C.)_____________________________________

(PLEASE INCLUDE A COPY OF YOUR CERTIFICATE OR LICENCE WITH THIS APPLICATION)

Is you business: ___Incorporated ___Partnership ___Proprietorship

How long in Business ___________________________________________________________

Is this Business a subsidiary of or related to any other existing customer ___YES ___NO

If Yes, please give names _________________________________________________________

This is a Wholesale Appliction only, NOT a Credit Application - all orders must be paid for prior to shipping. Applicant hereby agrees that all charges are payable according to our invoice. There is a 20% re-stocking fee applied to all returns (except scents/fragrances which are non-returnable). A $5.00 administration fee will be charged per-invoice for historical invoice re-prints. For customers outside of B.C. - please note that if you visit our store, both GST & PST taxes will be applied unless the goods you purchase are being shipped by Wicks & Wax outside of B.C. I hereby certify the foregoing to be true and to the best of my knowledge and agree to the terms above.

SIGNATURE___________________________ TITLE___________________ DATE________

Please Print this form and Fax to (604)294-1231 or email to candles@wicksandwax.com or post mail to Wicks & Wax - 3072 Beta Ave., Burnaby, BC, V5G 4K4 along with a copy of your PST Certificate or Business Licence.