Please submit complete and accurate information so that we can process your request for our wholesale catalog.

 All Items Marked with a Red " * " Are Required The form will not Submit Unless They are Answered.
Store Name:
*

Email Address: *
 
First Name:
*
Mailing Address:
 *
Last Name:
*
City: _______ _______State:
 * *
Resale # , ABN or VAT number
 *
Zip Code:
 *
Phone#:
*
Country:
 *
Fax#: If no Fax Number available enter NA
 *
Please Choose which best describes your business:
*
Website URL:

What other lines do you carry?
 *
Catalog Format
Mail Web and mail
Years in Business:
 *
How Did you hear about us:
 *
   
 

The information collected here is for the sole purpose of you the potential client to supply us with the necessary information to establish a business relationship with Stop Staring! It is necessary that you fill in all the information that is requested, so that we proccess your request as soon as possible.

At no time will this information be disclosed or supplied to any third party period! We value you privacy and wish to establish an excellent business relationship with you. If at any time you wish to update or change any of the information that we have for you please feel free to contact us at (213) 627-1480 PST . By submitting your information through this form you hereby give your consent for Stop Staring! to have use of your information to supply you with either electronic or mailed information. A representative may contact you (from stopstaringclothing.com) in regards to the information submitted either by phone or email, for us to verify that all information submitted  is true and correct.

Thank you, and we look forward to doing business with you.