Wholesale Customers WHOLESALE APPLICATION Being a wholesaler has many advantages. You get discounted rates on the whole line of Immortality Alchemy products. To qualify as a wholesaler, please fill out the form below. All applications are manually reviewed promptly. Please double-check your email address, as that's where we will send your login credentials once approved. Wholesaling ApplicationBeing a wholesaler has many advantages. You get discounted rates on the whole line of Immortality Alchemy products. To qualify as a wholesaler, please fill out the form below. All applications are manually reviewed promptly. Please double-check your email address, as that's where we will send your login credentials once approved.Business Name:* Business Name: Business Website: Buyer Name* First Last Phone*Email* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Tax identification number:Reseller identification number:Online or Physical Store?*Is your store a physical ("Brick and Mortar") or online? Check those that apply- if both, check both. Physical Online Tell us about your business:How long have you been in business? What do you specialize in? Minimum Price Agreement*1) I agree to the Immortality Alchemy LLC, Minimum Advertised Price (henceforth known as MAP) policy and will not advertise in any form (web, print, in store promotions or other forms of media) below the set MAP prices as listed on the Immortality Alchemy LLC Price list. 2) I agree to the minimum order amount of one case of any product (12 units). 3) I will pass on, in full, any promotional wholesale discount to my customers. 4) I understand that for free shipping my minimum order needs to be 3 full cases of product (36 units). If I order less than this amount I will pay 100% of the shipping. 5) I agree that I will be reselling these products and that they are not for personal use. 6) I confirm that this account is a genuine business and is not for personal use. 7) I understand that I cannot sell to other countries that already have listed distributors. I understand and agree to the Minimum Advertised Price Agreement Minimum Quantity Agreement*I agree that I will purchase at minimum a case at a time of any Immortality Alchemy product. No mixing and matching will count. I understand and agree to the Minimum Quantity Agreement Wholesaler Communications Agreement* I agree that I give my consent to get the Immortality Alchemy wholesaler newsletter - which will give me updates on the company, special promotions, and other communications from Immortality Alchemy.