UjENA Canada Wholesale NEW ACCOUNT

Privacy Information

All information collected on this form is used for the sole purpose of conducting business with your company, and is kept confidential. However, we may disclose information as required by governmental tax authorities. Also, when you order from our web site, we shall only disclose your billing information to our merchant processing bank so that we may collect payment.

** NOTE:If you are a U.S. based or International retailer, we suggest that you apply for your wholesale account at our U.S. based affiliate, UjENA Wholesale. Just click on the following link:

www.UjENAwholesale.com

Please fill out the form completely so that we may process your application. Do not leave any area blank. If you do not have an answer for each question asked, please fill in the answer area with something like " N.A. " or "No Info"

After we have approved your completed application, you will receive an email with your account information and instruction regarding accessing your account and making your first order. We appreciate your business. Thank You!

Business Address

Street
City
Province
Postal Code

You must have a business based in Canada in order to qualify to sell Ujena Products in Canada

Additional Information

Have you sold Ujena products in the past?	Yes	No
Do you currently sell Ujena products?	Yes	No

Please Check the box next to each of the following that pertain to your business.

Physical Retail Store
Multiple Locations
Franchisee
Franchiser
Please list other swimwear brands that you currently sell
Description of your business
Company Web Site URL

Primary Contact Information

First Name
Last Name
Email Address
Telephone
Title of Position
Fax

New Account Information

Username:
Password:
Confirm Password:

Credit Card Information

We will ask for your credit card and payment method information once you have been approved as our wholesale customer.

Terms And Conditions

I agree to the following terms and conditions

Because Ujena Canada Wholesale.com offers such an open order wholesale program, WE DO NOT ACCEPT ANY RETURNS OR EXCHANGES ON ANY WHOLESALE ORDERS except as listed below.

Any product(s) received incorrectly or have a manufacturing defect can be EXCHANGED. No credits or refunds will be issued. If an exact replacement is not available, a similar item of equal value will be substituted.

Company Name:
Company Type:
Business License ID:
G.S.T. Tax ID