937.550.9466 info@liberty-wear.com

Request for Membership


Minimum Opening Order:
$500
Minimum Re-Order:
$150, less will be charged a $5 minimum order fee.
Company Name:*
Store Type: *
Location Type: *
Number Of Years In Business:
Contact Name:*
Job/Position:*
Business Address:
Phone:
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Preferred Contact #:
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Reseller/ Tax ID:*
Website/ URL:
E-mail:*
E-mail confirmation:*

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Click Here to email your Resale ID and Tax ID information

Please be aware by applying for membership you may be contacted and emailed. You may also be sent news updates and promotions.*