The Wine Rack Company Dealership Application

We appreciate your interest in the The Wine Rack Company Dealership program. Please take a few minutes to tell us about yourself and your business. Once we receive your preliminary application, one of our Sales Managers will contact you to discuss how The Wine Rack Company can help you grow your business.

If you have more immediate questions, feel free to call us, toll-free at 888-687-2517

The Wine Rack Company Dealership Application

Business Name (required):

Contact Name (required):

Type of Business:

Mailing Address:

City:

State:

Zip Code:

Daytime Phone Number:

Email (required):

Website:

Business Details

Business License or TaxID Number:

Type of Business Entity (LLC, Sole Proprietor, Corp, etc):

Do you have Insurance?
Yes No 

Do you have a Showroom?
Yes No 

To what Trade Organizations do you belong, if any?

What areas do you serve?

Please provide at least 3 Trade References (clients, suppliers, associates)

Reference 1
Name
Mailing Address
Phone Number
Email Address

Reference 2
Name
Mailing Address
Phone Number
Email Address

Reference 3
Name
Mailing Address
Phone Number
Email Address